首页|基于失效模式和效应分析的静脉用药调配中心抗肿瘤药物管理策略研究

基于失效模式和效应分析的静脉用药调配中心抗肿瘤药物管理策略研究

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目的 探讨静脉用药调配中心(PIVAS)抗肿瘤药物采用失效模式和效应分析(FMEA)法来分析用药管理中的风险现状,并落实防范措施,提高用药安全性.方法 使用FMEA法对芜湖市第一人民医院PIVAS中的抗肿瘤药物管理环节中不同失效模式存在的风险进行分析,分别计算出风险优先值(RPN)评分,以RPN≥216 分作为中高风险点,针对其采取有效的防范措施,观察防范措施实施前后的效果.结果 经综合分析,找出了 8 个中高风险点,包括未认真检查临床退回药品、药品标识不够醒目、未严格执行核对制度、药品未溶解完全即混合、存在配伍禁忌、上药/药品归位错误、非整支药品未双人核对盖章、核对流程错误.针对各风险点实施防范措施前8 项中高风险点的RPN评分为(271.88±33.97)分,实施后 8 项中高风险点的RPN评分为(76.25±28.38)分,差异有统计学意义(P<0.05).与防范措施实施前比较,实施后调配差错率更低(P<0.05).结论 应用FMEA法对抗肿瘤药物调配环节进行用药管理,能够有效防范各项风险,减少药物调配错误率,保障医护人员及患者的安全.
Study on the management strategy of anticancer drugs in pharmacy intravenous admixture services based on failure mode and effect analysis
Objective To explore the application of failure mode and effect analysis(FMEA)to analyze the risk status of antitumor drugs in pharmacy intravenous admixture services(PIVAS),implement preventive measures,and to improve the drug safety.Methods FMEA method was used to analyze the risks of different failure modes in the management of antitumor drugs in PIVAS of Wuhu First People's Hospital,and the risk priority value(RPN)scores were calculated respectively.Taking RPN≥216 points as the medium and high risk points,effective preventive measures were taken for them,and the effects before and after the implementation of preventive measures were observed.Results After comprehensive analysis,8 medium and high risk points were identified,including failure to carefully check the returned drugs,insufficient identification of drugs,failure to strictly implement the verification system,mixing of drugs before complete dissolution,incompatibility,wrong placement of drugs,failure to check and seal non-whole drugs by two people,and incorrect verification process.After the preventive measures were taken,the RPN score of the medium and high risk points of the 8 items before implementation was(271.88±33.97)points,the RPN score of the medium and high risk points of the 8 items after implementation was(76.25±28.38)points and there was a statistical difference between them(P<0.05).Compared with before implementation of preventive measures,deployment error rate after implementation was lower(P<0.05).Conclusion FMEA method can effectively prevent risks and reduce the error rate of anti-tumor drug dispensing,thus ensuring the safety of medical staff and patients.

Failure modeEffect analysisPharmacy intravenous admixture servicesAntitumor drugDrug administration

杨典丽、李菁、俞亚静

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芜湖市第一人民医院药剂科(安徽芜湖 241000)

失效模式 效应分析 静脉用药调配中心 抗肿瘤药物 用药管理

安徽省卫生健康委科研项目

AHWJ2021b084

2024

中国药师
国家药品监督管理局高级研修学院,武汉医药(集团)股份有限公司

中国药师

CSTPCD
影响因子:0.944
ISSN:1008-049X
年,卷(期):2024.27(5)
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