深圳市三级医院静脉用药调配中心的现状与服务效能:基于13家医院的横断面调研

Current Situation and Service Efficiency of Pharmacy Intravenous Admixture Services in Tertiary Hospitals in Shenzhen:a Cross-Sectional Survey Based on 13 Institutions

目的:调研广东省深圳市三级医院静脉用药调配中心(PIVAS)的现状,为PIVAS的建设和发展提供参考。方法:设计问卷,对广东省深圳市三级医院的PIVAS进行多中心横断面调研,包含PIVAS开展时间、PIVAS数量、床位数目、面积、设备配备、人员模式、成本和收益等数据,分析各医疗机构中PIVAS建设的差异。结果:收集问卷13份,回复率为100%。PIVAS运行时间1~10年不等(中位数5年);建筑面积135~760 m^(2),其中≤500 m^(2)占53.85%(7/13),>500 m^(2)占46.15%(6/13);日均调配输液量≤500袋占53.85%(7/13),501~1000袋占15.38%(2/13),1001~2000袋占30.77%(4/13);PIVAS人员模式方面,采用药学管理占84.62%(11/13),药护管理占15.38%(2/13)。有84.62%机构认为PIVAS目前的普通药物与抗生素配置费收取不合理,100%认为PIVAS目前的抗肿瘤药物配置费、肠外营养配置费收取不合理。结论:近年来,广东省深圳市三级医院PIVAS逐步发展壮大,新开的PIVAS增加了许多信息化、智能化设备投入,成本也随之增加。因PIVAS工作人员紧缺,大部分医疗机构仅开展了部分液体调配,无法开展全院区的全医嘱调配。目前,总体的配置费标准偏低,一定程度上影响了PIVAS发展。

Objective:To investigate the current situation of pharmacy intravenous admixture services(PIVAS)in tertiary hospital in Shenzhen,so as to provide reference for the construction and development of PIVAS.Methods:A questionnaire was designed to perform a multi-center cross-sectional survey of PIVAS in tertiary hospitals in Shenzhen,Guangdong Province,including data such as development time of PIVAS,number of PIVAS,number of beds,area,equipment,staffing patterns,cost and benefits.Differences in construction of PIVAS in different medical institutions were analyzed.Results:Totally 13 questionnaires were collected,with a response rate of 100%.The development time of PIVAS ranged from 1 to 10 years(with the median of 5 years).The floor space of PIVAS ranged from 135 to 760 m^(2),with 53.85%(7/13)≤500 m^(2),and 46.15%(6/13)>500 m^(2).The average daily volume of dispensed infusion was 53.85%(7/13)for≤500 bags,15.38%(2/13)for 501 to 1,000 bags,and 30.77%(4/13)for 1,001 to 2,000 bags.As for the staffing patterns of PIVAS,the use of pharmacy management accounted for 84.62%(11/13),and pharmacy nursing management accounted for 15.38%(2/13).Totally 84.62%(11/13)institutions considered that the current allocation fees for generic drugs and antibiotics charged by PIVAS were irrational,and 100%considered that the current allocation fees for antineoplastic drugs and parenteral nutrition charged by PIVAS were irrational.Conclusion:In recent years,PIVAS in tertiary hospitals in Shenzhen,Guangdong Province,has developed well,and newly opened PIVAS increase many inputs of informatization and intelligent equipment,and the cost increases as well.Due to the shortage of PIVAS staff,most of the healthcare organizations only carry out partial liquid dispensing and are unable to carry out full medical dispensing for the whole hospital.Currently,the overall allocation fee standard is low,which affects the development of PIVAS.