规范化目录的实施对提升静脉用药调配中心加药混合调配准确性的效果评价

Evaluation of effect of implementation of standardized directory in improving accuracy of dosing and mixing of intravenous infusion in pharmacy intravenous admixture service

目的 评估规范化目录的实施对提高静脉用药调配中心(PIVAS)加药混合调配准确性的影响,提升成品输液质量。方法 实施《PIVAS加药混合调配规范化目录》,包含《输液瓶(袋)最大载液量规范化目录》《溶解加液量、注射器选择规范化目录》《溶解方法选择规范化目录》《非整支标准浓溶液配制规范化目录》及《药品抽吸操作规范化目录》5个子目录,规范西安市第三医院加药混合调配行为,并对实施前后效果进行评估。结果 规范化目录的实施规范了该院加药混合调配人员操作,显著提高了药物残留量达标率,平均升高20.83%,其中3种药物实施前后差异有统计学意义;新生儿肠外营养液质量误差率有降低趋势(1.73%比2.16%,P>0.05),同时显著降低了加药混合调配差错率(0.115‰比0.156‰,P<0.05),提高了加药混合调配的准确性。结论 规范化目录的实施有助于提高PIVAS加药混合调配的准确性,提高临床用药的安全性和有效性。

Objective To evaluate the effect of standardized directory implementation for improving dispensing accuracy and the quality of finished infusion of pharmacy intravenous admixture service(PIVAS).Methods Standardized directory of intravenous infusion dosing and mixing was implemented in PIVAS,which contained five subdirectories,i.e.,"the standardized directory of the maximum fluid volume that the transfusion bag/bottle can carry""the standardized directory of amount of fluid for dissolving drugs and choice of syringes""the standardized directory of dissolving methods""the standardized directory of standard solution preparation in incomplete dose drug",and"the standardized directory of drug suction operation".The operation of dosing and mixing was standardized,and the effects were evaluated before and after the implementation.Results Implementation of standardized directory in the hospital standardized the operation of intravenous infusion dosing and mixing,which significantly improved the rate of reaching the standard of drug residue,reduced the incidence of quality error of neonatal parenteral nutrition solution and the error rate of dosing and mixing,the average increase was 20.83%,and the difference between evaluated before and after in the three drugs was statistically significant.The quality error rate of neonatal parenteral nutrient solution has a decreasing trend(1.73%vs 2.16%,P>0.05).At the same time,the error rate of dosing and mixing was significantly reduced(0.115‰vs 0.156‰,P<0.05),and the accuracy of dosing and mixing were improved.Conclusion The implementation of standardized directory of intravenous infusion dosing and mixing in PIVAS is helpful to improve the accuracy of dosing and mixing and the safety and effectiveness of clinical drug use.