对静脉药物配置中心用药安全问题的思考

A discussion on the medication safety problems in Pharmacy Intravenous Admixture Service Center

目的:总结静脉药物配置中心的工作体会,以期持续质量改进,保证临床用药安全。方法:对本院静脉药物配置中心各工作环节出现的差错类型进行分析,提出相应的改进措施。结果:静脉药物配置中心差错主要表现为医师医嘱错误、药师调配错误、护师冲配错误及工勤人员的运送错误等。结论:按照JCI审评标准探索更有效的保障用药安全的方法,实施质量改进是一项持续性的工作。

Objective： To summarize the experiences in Pharmacy Intravenous Admixture Service （PIVAS） Center in order to improve the quality and ensure the safety of medication continuously. Methods： The different types of medication errors in PIVAS Center were analyzed and the corresponding measures for improving the quality of medication were proposed. Results： Medication errors in PIVAS Center mainly included prescribing faults made by doctors, dispensing mistakes made by pharmacists, infusion errors made by nurses, and delivery errors made by administrative workers. Conclusion： It is an on-going task to find out a more effective way to ensure the safety and improve the quality of medication in accordance with JCI standards.