摘要
目的:探究并建立评价医院口服拆零药品精细化管理方法,确保拆零药品质量,保证患者用药安全。方法:运用医疗失效模式与效应分析法(HFMEA)找出口服药品拆零全流程中的潜在失效模式及失效后果,进而分析改进措施并实施。制定《口服药品拆零管理制度》,实行拆零药品分级管理,从拆零药品品种、数量、有效期等各个环节进行把控。制作口服拆零药品裸片图库,提高药师对裸片的辨识能力,并采用现代化手段(如条形码、核对机等)进行拆零药品复核工作。将实施前后失效模式优先风险值(RPN)进行配对t检验。结果:应用HFMEA后,口服药品拆零各环节发生的失效模式RPN下降48.87%~52.31%,具有统计学差异(P<0.05)。结论:HFMEA的运用以及精细化管理措施,可以有效预防口服拆零药品各环节失效模式的发生,保障药品质量,确保患者用药安全。
Objective:To explore,establish and evaluate the management method of repackaged oral drugs in the hospital,ensuring the quality of repackaged drugs and the medication safety of patients.Methods:We used healthcare failure mode and effect analysis(HFMEA)to find out the potential failure modes and failure consequences in the whole process of repackaging oral drugs.Then,we analyzed and implemented the improvement measures accordingly.We developed the oral drug disassembly management system,implemented the hierarchical management of repackaged oral drugs,as well as monitored the variety,quantity,validity period and other steps of repackaged drugs.We formulated a photo library of bare oral solid forms to improve pharmacists’ability to identify repackaged drugs.Also,we used modern techniques such as bar code and verification machine to recheck repackaged drugs.The risk priority number(RPN)of failure modes before and after implementation was compared using paired t-test.Results:After the application of HFMEA mode,the RPN value of failure mode in each step of repackaged oral drug was decreased by 48.87%~53.31% with statistically significance(P<0.05).Conclusion:The application of HFMEA mode and refined management measures can effectively prevent the occurrence of failure modes in all steps of repackaging oral drugs,ensuring the drug quality and the medication safety of patients.
作者
李云娣
邱婷婷
孔宪伟
程吟楚
宋再伟
杨毅恒
LI Yun-di;QIU Ting-ting;KONG Xian-wei;CHENG Yin-chu;SONG Zai-wei;YANG Yi-heng(Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China)
出处
《中国合理用药探索》
2022年第5期96-101,共6页
Chinese Journal of Rational Drug Use
关键词
拆零药品
医疗失效模式与效应分析
用药安全
分级管理
精细化管理
repackaged oral drugs
healthcare failure mode and effect analysis
medication safety
hierarchical management
refined management
