医院静脉药物配置中心退药原因分析与对策

目的 探讨静脉药物配置中心退药问题,采取各种解决方法提高工作效率.方法 对上海市胸科医院2013年1-6月静脉药物配置中心的退药次数进行统计,并分析退药原因,提出相应的解决措施.结果 共统计退药11 932次,外科退药比例明显较高,最高的为胸外科[8.6％（2 538/29 576）],其次是心外科[8.5％（971/11 477）]、肿瘤科[6.1％（1 920/31 477）]、特需病区[5.7％（1 602/27 962）]与心内科[5.7％（659/11 455）],中西医病区[2.5％（187/7 335）]与放疗病区[2.8％（455/16 113）]退药比例较低.退药原因中,医师因素6 808次,占57.1％;护士因素566次,占4.7％;患者因素4 558次,占38.2％.结论 解决退药问题,做好与临床医师沟通丁.作并发挥药师作用,根据临床需求改变运行流程,以提高静脉药物配置中心工作效率.

Analysis of drug repercussion in pharmacy intravenous admixture services

Objective To analyze the reasons of drug repercussions in pharmacy intravenous admixture services（PIVAS）,and to improve the work efficiency through various solutions.Methods The drug repercussions of PIVAS in Chest Hospital Affiliated to Shanghai Jiao Tong University were recorded from January to June 2013.The continuous improvement measures were formulated.Results There was a total of 11 932 cases of drug repercussions.Drug withdrawal proportion of surgery was significantly higher than that of other departments.The highest was thoracic surgery [8.6% （2538/29576）],followed by cardiac surgery [8.5% （971/ 11 477）],oncology [6.1% （1 920/31 477）],special needs patients district [5.7% （1 602/27 962）] and cardiology [5.7% （659/11 455）].Drug withdrawal proportion of western medicine ward [2.5% （187/ 7 335）] and radiotherapy ward [2.8% （455/16 113）] were lower than that of other departments.Regarding the causes of drug repercussion,the ratio of doctors was 57.1% （6 808/11 932）,the ratio of nurses was 4.7%（566/11 932）,and the ratio of patients was 38.2% （4 558/11 932）.Conclusion Intravenous drug distribution center efficiency can be improved.