品管圈在提高我院PIVAS排药速度中的应用实践

Application of QCC in Improving Drug Dispensing Speed of PIVAS in Our Hospital

目的:为提高静脉药物集中调配中心(PIVAS)排药速度提供参考。方法:分析我院PIVAS排药速度慢的原因,按照品管圈实施的主题选定、计划拟定、现状把握、目标设定、解析目标、对策拟定、对策实施与检讨、效果确认、标准化、检讨与改进等十大步骤进行活动,以排药速度和排药差错率来评价品管圈活动成效。结果:输液袋位置不固定、预摆药筐数量不足、粘贴医嘱标签方式不统一、药品位置标识不醒目、药架摆放不合理是我院PIVAS排药速度慢的主要原因。通过采取按医嘱需求摆放输液、重新制作药架标识、提前准备充足预摆药筐及规范粘贴医嘱处方签等改进措施,我院PIVAS排药速度由活动前2.99袋/人/min提升到活动后的4.90袋/人/min,目标达成率为95%;通过改进和优化排药流程,排药差错率由活动前的0.005%降低至活动后的0.002%。结论:我院PIVAS开展的品管圈活动,通过改进和优化排药流程,不仅提高了排药速度,还降低了排药差错率。

OBJECTIVE： To provide reference for improving drug dispensing speed of pharmacy intravenous admixture services （PIVAS）. METHODS： The reasons for slow drug dispensing in PIVAS of our hospital were analyzed, quality control circle （QCC） activity was conducted according to ten steps as subject selection, plan formulation, current situation control, goal setting, goal analysis, countermeasure formulation, countermeasure implementation and review, effect confirmation, standardization, review and improvement. The effect of QCC activity was evaluated by drug dispensing speed and the rate of drug dispensing error. RESULTS： Main reasons for slow drug dispensing in PIVAS in our hospital included not fixed position of the infusion bag, insufficient pre-dispensing drug basket, not unified method of sticking doctor＇ s order labels, not eye-catching drug position identification, unreasonable drug shelf position. Drug dispensing speed increased from 2.99 bag/person/min to 4.90 bag/person/min, and the target yield rate was 95 % through displacing injection according to the doctor＇s order, re-making the drug shelf logo, preparing adequate pre-dispensing basket in advance, sticking the prescription tag of medical order standardly, etc. The rate of drug dispensing error decreased from 0.005 % to 0.002 % after improving and optimizing drug dispensing procedure. CONCLUSIONS： The application of QCC activity, improvement and optimization of drug dispensing procedure in PIVAS in our hospital not only improve drug dispensing speed in PIVAS, but also reduce the rate of drug dispensing error.