To mitigate risks associated with the prescription examination,marking,dispensing,checking,and review of non-integral-dosage drugs in Pharmacy Intravenous Admixture Service(PIVAS),we formed a project team.Employing th...To mitigate risks associated with the prescription examination,marking,dispensing,checking,and review of non-integral-dosage drugs in Pharmacy Intravenous Admixture Service(PIVAS),we formed a project team.Employing the failure mode and effect analysis(FMEA)management method,we identified potential risks in four critical steps of the non-integral-dosage drug dispensing process within PIVAS drug management:prescription verification,mixed allocation,and verification.For each step,we assigned scores for severity,incidence,and detectability,subsequently calculating the Risk Priority Number(RPN)to prioritize identified risks.Targeted measures for improvement were developed for steps with the highest RPN values.A total of 31 risk factors were documented in the management of non-integral-dosage drugs,with the dispensing process being particularly vulnerable.Specific measures were devised for eight high RPN risks.Following a 3-month optimization and improvement period,RPN values and incidences of internal differences were significantly reduced.The implemented measures demonstrated effective risk control.Notably,we established a comprehensive conversion system for partial-dose drug dispensing,directly translating into a volume of suction fluid for dispensing personnel based on doctor orders.This eliminated the need for manual secondary calculations,thereby standardizing and automating the dispensing of non-integral-dosage drugs in PIVAS.Simultaneously,our project team conducted a dissolution test on 23 types of drugs with non-integral dosage,revealing that the solvent volume increased for 11 types after dissolution.The dosage conversion for partial dosage was recalibrated based on the volume of the final solution to ensure dosage accuracy.Through the application of failure mode and effect analysis,we systematically managed the risks associated with non-integral-dosage drugs in PIVAS.This approach addressed safety concerns in the dispensing process,reduced errors,and ensured the safe and precise administration of medication to patients.展开更多
目的:基于美国医疗信息与管理协会(Healthcare Information and Management System Society)的理念,建立新型PIVAS药品闭环管理流程。方法:上海交通大学附属第六人民医院PIVAS实现了全流程药品条码化管理,通过条码扫描识别错误。结果:...目的:基于美国医疗信息与管理协会(Healthcare Information and Management System Society)的理念,建立新型PIVAS药品闭环管理流程。方法:上海交通大学附属第六人民医院PIVAS实现了全流程药品条码化管理,通过条码扫描识别错误。结果:本院正式通过HIMSS电子病历模型六级现场评审,PIVAS药品闭环管理提高了医务人员的工作效率、药品调配效率和准确性,踪近差错率由传统管理(2016年1月-6月)的0.17‰下降至信息化管理(2017年1月-6月)的0.08‰,降低了52.9%。结论:PIVAS药品闭环管理有利于保证病人的安全用药。展开更多
基金Anhui Provincial Health Research Project Fund(Grant No.AHWJ2023-BAc20143)Pharmaceutical Research Exploration Fund of the First Affiliated Hospital of University of Science and Technology of China(Grant No.YJKJJ04)14th Five Year Plan Anhui Province Medical and Health Clinical Key Specialty Construction Project Support.
文摘To mitigate risks associated with the prescription examination,marking,dispensing,checking,and review of non-integral-dosage drugs in Pharmacy Intravenous Admixture Service(PIVAS),we formed a project team.Employing the failure mode and effect analysis(FMEA)management method,we identified potential risks in four critical steps of the non-integral-dosage drug dispensing process within PIVAS drug management:prescription verification,mixed allocation,and verification.For each step,we assigned scores for severity,incidence,and detectability,subsequently calculating the Risk Priority Number(RPN)to prioritize identified risks.Targeted measures for improvement were developed for steps with the highest RPN values.A total of 31 risk factors were documented in the management of non-integral-dosage drugs,with the dispensing process being particularly vulnerable.Specific measures were devised for eight high RPN risks.Following a 3-month optimization and improvement period,RPN values and incidences of internal differences were significantly reduced.The implemented measures demonstrated effective risk control.Notably,we established a comprehensive conversion system for partial-dose drug dispensing,directly translating into a volume of suction fluid for dispensing personnel based on doctor orders.This eliminated the need for manual secondary calculations,thereby standardizing and automating the dispensing of non-integral-dosage drugs in PIVAS.Simultaneously,our project team conducted a dissolution test on 23 types of drugs with non-integral dosage,revealing that the solvent volume increased for 11 types after dissolution.The dosage conversion for partial dosage was recalibrated based on the volume of the final solution to ensure dosage accuracy.Through the application of failure mode and effect analysis,we systematically managed the risks associated with non-integral-dosage drugs in PIVAS.This approach addressed safety concerns in the dispensing process,reduced errors,and ensured the safe and precise administration of medication to patients.
文摘目的:基于美国医疗信息与管理协会(Healthcare Information and Management System Society)的理念,建立新型PIVAS药品闭环管理流程。方法:上海交通大学附属第六人民医院PIVAS实现了全流程药品条码化管理,通过条码扫描识别错误。结果:本院正式通过HIMSS电子病历模型六级现场评审,PIVAS药品闭环管理提高了医务人员的工作效率、药品调配效率和准确性,踪近差错率由传统管理(2016年1月-6月)的0.17‰下降至信息化管理(2017年1月-6月)的0.08‰,降低了52.9%。结论:PIVAS药品闭环管理有利于保证病人的安全用药。
