某院静脉药物调配中心差错分析与防范

Error analysis and prevention in pharmacy intravenous admixture service of the hospital

目的通过分析静脉用药调配中心在实际工作中经常出现差错的环节,并提出针对性的防范措施。方法对静脉用药调配中心登记的差错进行归类,并应用统计学方法计算其差错出现的概率。结果出现成品输液差错的有432袋,占0.064%;其中医嘱审核错误为5例,占1.16%;摆药错误为152例,占39.19%;调配错误为119例,占27.55%;成品输液质量问题为65例,占15.05%;退费已加为21例,占4.86%;输液污染为40例,占9.26%;其他原因为30例,占6.94%。结论通过对各种常见的出现频率较高的差错进行详细的分析并提出有效合理的解决方案和建议,对推动静脉调配中心的发展,提升合理用药水平提供基础。

Objective Through the analysis of the links that often appear errors in the actual work of the intravenous drug dispensing center in our hospital,and the corresponding preventive measures.Methods The errors registered in the intravenous drug dispensing center were classified,and the probability of errors was calculated by statistical method.Results There were 432 bags(0.064%)in the final product transfusion error,5 cases(1.16%)of the final product transfusion error,152 cases(39.19%)of the finished product transfusion error,5 cases(1.16%)of the doctor's order audit error and 152 cases(39.19%)of the finished product transfusion error.The allocation error was 119 cases,which accounted for 27.55%of the finished product infusion error,65 cases of the finished product infusion quality problem,accounting for 15.05%of the finished product infusion error,21 cases of the refund fee,which accounted for 4.86%of the finished product infusion error.There were 40 cases of transfusion contamination,accounting for 9.26%of the finished product transfusion error,and 30 cases of other reasons,accounting for 6.94%of the finished product transfusion error.Conclusion Through the detailed analysis of various common errors with high frequency and putting forward effective and reasonable solutions and suggestions,we can promote the development of our hospital's venous distribution center,promote the level of rational use of drugs.