我院静脉药物调配中心成品输液临床退回原因分析及干预对策

Analysis on the Causes of Clinical Return of PIVAS Finished Infusions in Our Hospital and Discussion on Intervention Strategies

目的:为减少成品输液临床退回提供参考。方法:对我院静脉药物调配中心(PIVAS)成品输液的临床退回干预措施进行介绍,比较干预前(2013-2014年)、干预后(2015-2016年)成品输液退回情况,并对干预效果进行评价。结果:我院PIVAS通过合理选用注射器,加强配送前成品输液可见性微粒的检查;优化药物的配制顺序,合理安排药物输注顺序;加强药物输注前各环节工作区域的清理,正确使用消毒剂;严格执行静脉输液相关操作,发挥药师作用;培养良好的工作习惯,加强团队协作等措施进行干预。干预后成品输液退回数量相比干预前减少41.2%,报损金额减少45.7%,其中可见性微粒、成品输液存放时间过长氧化变色、成品输液漏液、药品连续输注配伍反应、外差错误、打包至病区的药物配制方法不当、输注前消毒剂使用不当等原因导致的退回相比干预前分别减少25.3%、46.9%、39.4%、77.8%、73.9%、75.0%、100%。结论:对成品输液退回进行干预可减少退回数量,减少药品浪费。

OBJECTIVE：To provide reference for reducing the clinical return of finished infusions. METHODS：Interventions for clinical return of PIVAS finished infusions in our hospital were introduced,the return situation of finished infusions before（during 2013-2014）and after（during 2015-2016）intervention was compared,and intervention effects were evaluated. RESULTS：Our hospital intervened it by rationally selecting and using syringes,strengthening visible particle check of finished infusion before distribution;optimizing the order of drug configuration,reasonably arranging the drug infusion sequence;strengthening the clean-up in work area before drug infusion,correctly using disinfectant;strictly implementing intravenous infusion associative operation,playing the role of pharmacists;cultivating good work habits,and strengthening teamwork,etc. Compared with before intervention,the return numbers of finished infusion were decreased by 41.2%,and reported loss amount reduced by 45.7%. The return caused by visibility particles,finished infusion oxidation discoloration after too long storage time,finished infusion leakage,continuous infusion of drugs compatibility,heterodyne error,improper drug configuration method in packaging to the ward,improper use of disinfectant before infusion decreased by 25.3%,46.9%,39.4%,77.8%,73.9%,75.0%,100%,respectively. CONCLUSIONS：Intervening the return of finished infusion can reduce the return numbers and drug waste.