本文關(guān)鍵詞： 失效模式與效應(yīng)分析 靜脈用藥集中調(diào)配中心 風(fēng)險(xiǎn)評(píng)估 退藥歸位差錯(cuò)　出處：《中國藥房》2017年28期 　論文類型：期刊論文

【摘要】：目的:降低靜脈用藥集中調(diào)配中心(PIVAS)退藥歸位差錯(cuò)率。方法:應(yīng)用失效模式與效應(yīng)分析(FMEA)方法,以風(fēng)險(xiǎn)優(yōu)先(RPN)值評(píng)估PIVAS退藥歸位環(huán)節(jié)中潛在的失效模式,并探討該環(huán)節(jié)可能造成差錯(cuò)的原因,提出降低退藥歸位差錯(cuò)率的可行性方案,并評(píng)價(jià)實(shí)施3個(gè)月后的干預(yù)成效。結(jié)果:在PIVAS退藥歸位環(huán)節(jié)中共找出未嚴(yán)格執(zhí)行雙人核對制度(RPN值為100)、不熟悉"看似"藥品(RPN值為36)、退藥數(shù)量多(RPN值為20)等8項(xiàng)高風(fēng)險(xiǎn)失效模式。據(jù)此制定了嚴(yán)格執(zhí)行雙人核對制度、優(yōu)化PIVAS管理系統(tǒng)等相應(yīng)的風(fēng)險(xiǎn)管控措施。經(jīng)過3個(gè)月的干預(yù)管理后,前3項(xiàng)的RPN值分別降為20、16、8,退藥歸位差錯(cuò)率由1.98%降低為0.62%(P0.05)。結(jié)論:我院PIVAS應(yīng)用FMEA方法,降低了退藥歸位差錯(cuò)率。
[Abstract]:Objective: to reduce the error rate of drug withdrawal and return in central intravenous drug dispensing center (PIVAS.Methods: the method of failure mode and effect analysis was used to analyze FMEA). To evaluate the potential failure mode in PIVAS return link with the value of risk first, to discuss the possible causes of errors in this link, and to put forward a feasible scheme to reduce the error rate of drug return and return. The effect of intervention after 3 months was evaluated. Results: the results showed that the double check system was not strictly carried out in the return of PIVAS and the RPN value was 100). It is not familiar with 8 high-risk failure modes, such as "seemingly" drugs with a RPN value of 36 渭 and a large number of drug returns with a RPN value of 20). Based on this, a strict double check system has been established. Optimization of PIVAS management system and other corresponding risk management measures. After 3 months of intervention management, the RPN of the first three items were reduced to 20 / 16 / 8 respectively. The error rate of drug return was reduced from 1.98% to 0.62P 0.050.Conclusion: FMEA method is used in PIVAS of our hospital to reduce the error rate of drug return and return.
【作者單位】： 泰山醫(yī)學(xué)院附屬醫(yī)院藥劑科;
【分類號(hào)】：R95
【正文快照】： *主管護(hù)師。研究方向:靜脈用藥集中調(diào)配管理。電話:0538-6231018。E-mail:lmh02.good@163.com失效模式與效應(yīng)分析(Failure mode and effect analy-sis,FMEA)方法是一種前瞻性預(yù)防安全隱患的分析方法,由失效模式和效應(yīng)分析兩部分組成。失效模式是指能被觀察到的錯(cuò)誤和缺陷(俗稱

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