我院静脉用药调配中心药品损耗分析和对策

目的探讨降低静脉用药调配中心（PIVAS）配置流程中药品损耗的方法和策略。方法对2012年度上半年我院PIVAS的药品损耗按照配置流程进行分类,对相关流程的损耗原因进行整理分析,并制定可行的对策;2012年度下半年实施干预措施和对策,通过比较干预对策前后6个月的各个环节的药物损耗种类数来评价干预的成效,应用SPSS19进行检验。结果对损耗原因实施针对性措施和对策干预后,其中7个配置环节（出厂药品存在破损、空包等,拆除包装时操作不当,调配操作原因造成药物的破损,药物冲配错误,冲配操作不当漏液,原包装漏液和其他）的药品损耗例数有明显减少,差异有统计学意义（P〈0．05）;2个配置环节（冲配中输液变色浑浊和药物上架、摆放、搬运）的药品损耗例数没有显著减少（P〉0．05）。结论针对每个配置环节的损耗原因,制定可行的策略,改进工作流程,可以有效的减少药物损耗。针对其中2个配置环节（冲配中输液变色浑浊和药物上架、摆放、搬运）,原有的措施对减少药物损耗无明显改善,故仍需继续改进。

Drug consumption problem analysis and strategy in pharmacy intravenous admixture service

AIM To discuss methods and strategies reducing drug consumption in pharmacy intravenous admixture service （PIVAS）. METHODS The drug consumption in PIVAS by workflow during the first half year of 2012 was classified. The causes of the drug cansumption were analyzed and the applicable strategies were made. The management and strategies were applied during the second half year of 2012. The effects of intervention by comparing drug consumption in all aspects before and after intervention were ewtluated, while chi-squared test was applied in SPSS 19 software. RESULTS After the intervention by implementation of targeted measures against loss causes and strategies, drug consumption by seven causes （package in damaged condition, improper package removal, improper drug dispensing, admixture error, leakage by improper handling, original package leakage and others） had been significantly reduced and showed significant difference （ P 〈 0.05）. Two causess （color change and turbidity while admixturing as well as drug mounting, placement and transportation） of drug consumption showed no significant reduction （ P 〉 0.05）. CONCLUSION For drug consumption causes in all aspects, developing applicable strategies and improving workflow can effectively reduce drug consumption. For two causes （color change and turbidity while admixturing as well as drug mounting, placement and transportation）, the original strategies show no significant improvenment to reduce drug consumption. Therefore strategies still need to be improved.