基于FMEA的PIVAS不合理医嘱风险评估和管理

Risk Management Using FMEA to Assess PIVAS Irrational Prescriptions Medication

目的降低PIVAS不合理医嘱率,减少住院输液风险。方法应用医疗风险管理方法,识别PIVAS不合理医嘱产生的用药风险及可能导致危害的风险环节,并采用FMEA原理进行风险评估,改良工作环节,降低并控制风险。结果对PIVAS不合理医嘱审核工作进行风险管理后,平均风险优先指数明显降低;不合理医嘱发生率明显下降,药师干预成功率明显提高;药师不合理医嘱的漏审率降低,相关人员风险意识也有所加强。结论通过医疗风险管理有效降低了不合理医嘱率,减少了临床用药风险。

OBJECTIVE To reduce the rate of irrational prescriptions and the risk of hospital infusion in PIVAS. METHODS Applying of medical risk management method, identify drug risk arising from irrational prescriptions of PIVAS and risk areas it may caused, and use FMEA principle for risk assessment, in order to improve work and control risks. RESULTS After applying of risk management on PIVAS irrational prescriptions, risk priority index（RPN） values were significantly lower, the incidence rate of irrational medical order had dropped significantly; the success rate of pharmacists intervention also increased significantly; the rate of irrational medical order leakage had dropped, and the risk awareness of related personnel had also been strengthened. CONCLUSION By applying of medical risk management, the rate of irrational prescriptions and the risk of clinical drug reduce effectively.