静脉药物配置中心工作流程的持续改进

Continuous improvement of the workflow of pharmacy intravenous admixture services

目的持续完善静脉药物配置中心的管理制度以及工作质量,提高静脉用药安全,减少配置差错。方法通过部门集体讨论工作流程中存在的缺陷及导致其产生的因素,根据缺陷的轻重缓急及改进的可能性,选择某些目标,运用PDCA模式不断改进静脉药物配置中心的工作,提高质量管理,优化工作流程。结果通过一系列措施的逐步改进,使静脉药物配置中心的工作顺畅度增加。不合理医嘱错误退药贴数比例最高由56.7%减少到了29.8%。同时增加双人贴签核对流程后,2013年10~12月与2014年同期相比,总的不合理医嘱漏审率由18.0%降至2.7%,尤其降低了配伍禁忌和用药经济性不合理医嘱进入配置环节,减少药品浪费。结论运用PDCA模式对工作流程进行优化,能有效降低药物配置差错,为临床用药安全提供保障,并通过不断增加工作的流畅度,更好地为临床服务。

Objective To improve the management system of pharmacy intravenous admixture services( PIVAS) continually,as well as the work quality,and reasonably improve the medication safety and reduce the errors of configuration. Methods The defects in the workflow and the factors that lead to the defects were discussed. According to the priorities of the possibility of defects and improved,some of the goals were seted up,and the quality of management was improved and the workflow was optimized constantly by using the PDCA model. Results With a series of measures was taking,the working of PIVAS became much smoother. The number of error prescription posted the highest percentage decreased from 56. 7% to 29. 8%. After added the process which have two persons to label and verification,from October to December in 2013 compared with the same period in 2014,the rate of missing audit of irrational prescriptions decreased from 18. 0% to 2. 7%,reduced the incompatibility and economy irrational prescriptions into the configuration link and reduced waste drugs in particularly. Conclusion Using PDCA model to optimize the workflow,can effectively reduce the errors of drug allocation,as well as provide the protection for clinical drug safety,and serve for clinical work better by increasing the flow of work.