北京市二级及以上医院麻醉科麻精药品管理现状及分析

Current status and analysis of the management of narcotic and psychotropic drugs in the department of anesthesiology at hospitals of secondary and higher level in Beijing

目的调查北京市二级及以上医院麻醉科麻醉药品、精神药品管理情况,为不同级别医院麻醉科对于麻精药品管理提供依据。方法通过北京市临床麻醉质量控制和改进中心平台由专人一对一对有麻醉科建制的二级以上医院发放问卷星链接,调查问卷包括医院基本信息,目前麻醉科内麻精药品管理制度、使用现状以及建议等内容。结果本次调查共发放问卷159份,共回收有效问卷139份,其中二级医院及其他专科医院50家,三级综合医院89家,有效回收率为87.4%。调查结果显示北京市二级及以上医院麻醉科主要使用的麻精药品种类:枸橼酸舒芬太尼注射液、注射用盐酸瑞芬太尼、盐酸麻黄碱注射液、枸橼酸芬太尼注射液等。参与药品管理的人员包括麻醉科医生(63.3%)、麻醉科护士(45.3%)、手术室护士(45.3%)、临床药师(11.5%),存在交叉共管现象。在管理和使用麻精药品过程中存在的主要问题包括药品积压过期浪费(36.4%)、麻精药品无处方或处方错误(31.8%),不同药品存放问题、管理人员数量有限但身兼多职等问题。结论北京市不同级别医院麻醉科在法律规范基础上应结合自身特点建立麻精药品管理制度,明确岗位职责、规范临床人员资质,建议可引入智能化药车、设立麻醉科护士岗位,提升麻精药品管理效率。

Objective To investigate the management of narcotic and psychotropic drugs in the department of anesthesiology at hospitals of secondary and higher level in Beijing,and provide a basis for the drug management in the department of anesthesiology of different levels of hospitals.Methods Through the platform of Beijing Center of Quality Control and Improvement for Clinical Anesthesia,a questionnaire star link was issued to hospitals of secondary and higher level,which have established anesthesia departments by authorised personnel.The content of questionnaire includes basic hospital information,the current management system and usage status of narcotic and psychotropic drugs in the anesthesia department,as well as suggestions.Results A total of 159 questionnaires were issued in this survey,and 139 valid questionnaires were recovered,including 50 secondary hospitals and other specialized hospitals and 89 tertiary general hospitals,with an effective recovery rate of 87.4%.The main types of narcotic and psychotropic drugs used in the department of anesthesiology at hospitals of secondary and higher level in Beijing are sufentanil citrate injection,remifentanil injection,ephedrine hydrochloride injection,and fentanyl citrate injection.The personnel involved in drug management include anesthesiologists(63.3%),nurses in the anesthesia department(45.3%),operating room nurses(45.3%),clinical pharmacists(11.5%).There is a phenomenon of cross management.The main problems in the management and of anesthesia drugs use include expired waste caused by drug backlog(36.4%),and lack of prescription or incorrect prescription of narcotic and psychotropic drugs(31.8%),also problems with different drug storage,limited number of management personnel but multiple roles,etc.Conclusion The department of anesthesiology of hospitals at different levels in Beijing should establish narcotic and psychotropic drugs management system based on legal norms and their characteristics,clarify the qualifications of narcotic and psychotropic drugs management personnel.It is suggested that intelligent drug vehicles be introduced and anesthesia nursing positions be set up for improving the efficiency of narcotic and psychotropic drugs management.