医疗FMEA结合ST-PRA在西药房高危药品管理与用药安全中的应用

Application of Medical FMEA Combined with ST-PRA in the Management of High-risk Drugs and Drug Safety in Western Pharmacies

目的:探讨医疗失效模式和效应分析(FMEA)结合社会技术概率风险评估(ST-PRA)在西药房高危药品管理与用药安全中的应用效果。方法:选取本院2019年1月—2020年12月在职工作的药房工作人员40名,按照管理方法不同区别其为试验组及对照组,每组20例。对照组采用传统高危药品管理,试验组采用医疗FMEA结合ST-PRA联用药品管理,比较两组RPN指数及给药错误率,并通过模糊综合评价法量化比较工作人员药品审核、药品调剂及存放、失效或无标识药品处理、处方开具、用药安全性5项高危药品管理水平。结果:试验组RPN总值为236,低于对照组的2514(P<0.05);试验组给药错误率为2.64%,低于对照组的10.03%(P<0.05);试验组工作人员的药品审核、药品调剂及存放、失效或无标识药品处理、处方开具、用药安全性评分高于对照组(P<0.05)。结论:医疗FMEA结合ST-PRA有助于降低西药房的RPN值,减少其给药错误率,并且能够提高西药房的高危药品管理质量。

Objective:To explore the application effect of medical failure mode and effect analysis(FMEA)combined with social technical probabilistic risk assessment(ST-PRA)in the management of high-risk drugs and drug safety in western pharmacies.Methods:A total of 40 pharmacy staff working in our hospital from January 2019 to December 2020 were selected and divided into experimental group and control group according to different management methods,with 20 cases in each group.The control group was treated with traditional high-risk drug management,and the experimental group was treated with medical FMEA combined with ST-PRA drug management.The RPN index and error rate of administration were compared between the two groups.The fuzzy comprehensive evaluation method was used to quantify and compare the five high-risk drug management levels of staff drug audit,drug dispensing and storage,invalid or unmarked drug treatment,prescription opening and medication safety.Results:The total RPN value in the experimental group was 236,which was lower than 2514 in the control group(P<0.05);the medication error rate in the experimental group was 2.64%,which was lower than 10.03%in the control group(P<0.05).The scores of drug audit,drug dispensing and storage,invalid or unmarked drug treatment,prescription formulation and medication safety of the experimental group were higher than those of the control group(P<0.05).Conclusion:Medical FMEA combined with ST-PRA can help reduce the RPN value of western pharmacies,reduce the error rate of administration,and improve the quality of high-risk drugs management in western pharmacies.