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目的:探讨《美国医疗卫生机构评审国际联合委员会医院评审标准》(JCI标准)在我院静脉药物配置中心(PIVAS)的应用实践。方法:对JCI用于PIVAS管理设计、工作及医嘱时间安排、人员管理、输液质量或故障管理应急预案等方面进行探讨,分析总结PIVAS设计理念及管理模式。结果:JCI标准引入后,我院PIVAS从管理制度与工作流程设计、净化系统与物流划分设计、信息系统设计等方面加以改进;工作时间以工作量、工作流程和临床科室的实际需要进行安排;医嘱改进为每小时1批次,全天24批次,按时间点送达临床科室;PIVAS人员的积极性得到提高,工作实现量化并实行绩效考核。结果显示,药品调配流程得以优化,信息化管理职责明确,成品输液质量得以保障;每月对工作差错分析总结,工作差错由JCI标准引入前(2013年)的562例减少为引入后(2014年)的264例,年度差错率降幅达到112.87%。结论:JCI标准对于推动PIVAS的管理,提高工作水平和质量,保障临床用药安全、合理,具有非常重要的意义。
OBJECTIVE: To discuss the application practice of PIVAS standardization in pharmacy intravenous admixture service (PIVAS) of our hospital. METHODS: Based on JCI, the design concept and management mode of PIVAS were analyzed and summarized from PIVAS design, management, job and medical order time arrangement, staff management, infusion quality or fault emergency plan, etc. RESULTS: After introducing JCI standards, the improvement was conducted in respects of management system and work flow design, purification system and logistics division design, information system design, etc. Working hour was arranged according to the workload or work flow and the actual needs of clinical departments. Medical orders, 1 batch per hour, 24 batches one day, were delivered to clinical departments according the time point. The positivity of the staff had been improved, and work quantization and performance appraisal had been achieved. Those improvement optimized drug dispensing process, cleared the responsibility of information management and guaranteed the quality of infusion. Work error analysis and summary were monthly conducted; the number of work error decreased from 562 cases before JCI introduction (2013) to 264 cases after JCI introduction (2014), decreasing by 112.87% annually. CONCLUSIONS: JCI standard is of significance to the promotion of PIVAS management, work level and quality, and safe and rational use of drugs in the clinic.
JCI标准静脉药物配置中心规范化管理
JCI standardPharmacy intravenous admixture servicesStandard management
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