静脉用药调配中心精准冲管智能提示系统的建立

Establishment of intelligent prompt system of precise flushing in pharmacy intravenous admixture service

目的:建立基于提高用药安全性和有效性的静脉用药调配中心(PIVAS)精准冲管智能提示系统。方法:建立序贯输注输液管内(组间)配伍禁忌知识库。采用Windows通讯开发平台(WCF)数据通道技术和面向服务的架构(SOA)设计方法,对存在组间配伍禁忌的医嘱药品名称前提示“禁忌”。药师将存在组间配伍禁忌的2组输液以第3种输液间隔开或提示冲管,避免序贯输注组间配伍禁忌的发生。结果:1个自然日内,提示存在组间配伍禁忌输液的患者占总住院患者的18.58%;提示存在组间配伍禁忌的输液组数占总序贯输液组数的20.39%,其中可以用第3种输液加以间隔的占68.91%,无法间隔而需冲管的占31.09%。设置精准冲管智能提示后,每个病区的冲管次数由51.63次/d减少到2.24次/d,冲管的输液费用由226.89万元/年降低到9.81万元/年。结论:PIVAS建立了基于提高用药安全性和有效性的智能提示系统,可精准判定是否需要冲管,有效避免了组间配伍禁忌的发生。

Objective:To establish an intelligent prompt system of precise flushing in the pharmacy intravenous admixture services(PIVAS)for the purpose of further improving medication safety and efficacy.Methods:A sequential infusion(intra-group)compatibility contraindication knowledge database was established in the study.The Windows communication foundation(WCF)data channel technology and service-oriented architecture(SOA)design method were applied to indicate warnings for the drugs that have intra-group incompatibility.The pharmacists separated the incompatible intra-group infusions with a third infusion or flushing to avoid occurrence of sequential contraindications.Results:In one day,18.58%of the total number of hospitalized patients was contraindicated,and 20.39%of the total infusion groups was contraindicated,of which 68.91%could be separated by the third infusion and 31.09%could not be separated,and flushing was needed.With the assistance of the intelligent prompt system,the precise flushing method reduced the number of flushing from 51.63 times per day to 2.24 times per day in each ward,and the cost of flushing reduced from 2268.9 thousand yuan to 98.1 thousand yuan per year.Conclusion:PIVAS established an intelligent prompt system for the purpose of improving medication safety and efficacy,and it could accurately determine whether flushing was required,thus effectively avoiding intra-group incompatibility.