Construction and application of total quality management system in pharmacy intravenous admixture service

FANG Baoxia; WU Songchao; LIU Jing; WANG Sicen; CHEN Fuchao

doi:10.6039/j.issn.1001-0408.2023.15.02

您当前的位置：

首页 >

文章列表页 >

Construction and application of total quality management system in pharmacy intravenous admixture service

更新时间：2025-09-26

- Construction and application of total quality management system in pharmacy intravenous admixture service
- ZHONGGUO YAOFANG Vol. 34, Issue 15, Pages: 1798-1803(2023)
- 作者机构：
  
  1.湖北医药学院附属国药东风总医院药学部，湖北十堰　442008
  2.西安交通大学医学部药学院，西安　710061
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.15.02
  CLC： R95
- Received：30 December 2022，
  
  Revised：2023-07-09，
  
  Accepted：10 July 2023，
  
  Published：15 August 2023
- 稿件说明：
移动端阅览
方宝霞,吴松潮,刘菁,等.静脉用药集中调配中心全面质量管理体系的构建与应用[J].中国药房,2023,34(15):1798-1803.

FANG Baoxia,WU Songchao,LIU Jing,et al.Construction and application of total quality management system in pharmacy intravenous admixture service[J].ZHONGGUO YAOFANG,2023,34(15):1798-1803.
方宝霞,吴松潮,刘菁,等.静脉用药集中调配中心全面质量管理体系的构建与应用[J].中国药房,2023,34(15):1798-1803. DOI： 10.6039/j.issn.1001-0408.2023.15.02.

FANG Baoxia,WU Songchao,LIU Jing,et al.Construction and application of total quality management system in pharmacy intravenous admixture service[J].ZHONGGUO YAOFANG,2023,34(15):1798-1803. DOI： 10.6039/j.issn.1001-0408.2023.15.02.

摘要

目的

构建静脉用药集中调配中心（PIVAS）全面质量管理体系，促进临床静脉输液的规范化、精确化、合理化。

方法

依托医院PIVAS信息系统，制定PIVAS输液配制前、配制中及配制后全流程的管理制度、确定质量监控项目，以PDCA循环、品管圈、根因分析等质量管理工具与方法，定期进行质控与质量改进。回顾性分析PDCA循环干预前（2019年）及干预后（2020、2021年）PIVAS主要质控指标情况。

结果

PIVAS输液配制全过程的质量监测指标如药品质量管理得分、药液残留量合格率与输液配制含量合格率分别由2019年的92分、79%、86.4%提高至2021年的99分、92%、99.8%；安全合理用药指标如静脉输液不合理医嘱占比、退药率、抗菌药物使用率、中药注射剂使用率分别由0.98%、6.1%、40.55%、39.70%降至0.23%、3.2%、37.18%与26.00%。

结论

构建的PIVAS全面质量管理体系能提升输液配制过程中质量管理水平，提高输液配制质量，促进临床安全合理用药。

Abstract

OBJECTIVE

To establish a total quality management system for pharmacy intravenous admixture services （PIVAS）， in order to promote the standardization， accuracy and rationalization of clinical intravenous infusion.

METHODS

Based on information system in PIVAS， the management system and quality monitoring items of the whole process before， during and after PIVAS infusion preparation were formulated. The quality control and quality improvement were carried out regularly with quality management tools and methods such as PDCA （plan， do， check， process） cycle， quality control circle， and root cause analysis. The main quality control indexes of PIVAS were retrospectively analyzed before （in 2019） and after PDCA cycle management （in 2020 and 2021）.

RESULTS

The indexes of quality monitoring in the whole process of PIVAS infusion preparation， such as the score of drug quality management， the drug residue qualification rate and the qualified rate of drug content in infusion， were increased from 92 points， 79%， 86.4% in 2019 to 99 points， 92%， 99.8% in 2021， respectively. The indexes of safe and rational drug use， such as the ratio of intravenous irrational medical orders， the rate of drug repercussion， the rate of antibiotics use， and the rate of TCM injection use decreased from 0.98%， 6.1%， 40.55%， 39.70% to 0.23%， 3.2%， 37.18%， 26.00%， respectively.

CONCLUSIONS

The established total quality management system for PIVAS can improve the quality management level in the infusion preparation process， improve the quality of infusion preparation and promote clinical safe and rational drug use.

关键词

Keywords

references

吕红梅，吴永佩 . 我国静脉用药集中调配模式的创建与现状 [J ] . 中国药房， 2021 ， 32 （ 6 ）： 641 - 646 .

庞国勋，王涛，靳会欣 . 我国静脉用药集中调配中心可持续发展的关键要素分析 [J ] . 中国药房， 2020 ， 31 （ 23 ）： 2901 - 2908 .

YANG C S ， KANG B Y ， ZHANG L L ， et al . Construction situation，costs and charges associated with pharmacy intravenous admixture services：multi-center cross-sectional survey based on 137 medical institutions in Mainland of China [J ] . BMC Health Serv Res ， 2020 ， 20 （ 1 ）： 577 .

李秋月，李扎石，赵怀碧，等 . 基于文献计量学的我国静脉用药调配中心研究进展可视化分析 [J ] . 中国药房， 2022 ， 33 （ 15 ）： 1881 - 1886 .

余茜，李广辉，彭昊帅，等 . 我院静脉用药集中调配中心质量控制监测体系的实施与评价 [J ] . 中国药房， 2017 ， 28 （ 34 ）： 4846 - 4849 .

ALZOUBI M M ， HAYATI K S ， ROSLIZA A M ， et al . Total quality management in the health-care context：inte- grating the literature and directing future research [J ] . Risk Manag Healthc Policy ， 2019 ， 12 ： 167 - 177 .

HAMIDI Y ， MOGHADAM S M K ， HAZAVEHEI S M M ， et al . Effect of TQM educational interventions on the management policy standard of health promoting hospitals [J ] . Health Promot Int ， 2021 ， 36 （ 2 ）： 397 - 405 .

曾双双，王栋，刘万里，等 . 基于“医-药-护”预警监控系统的合理安全输液整合管理实践 [J ] . 中国医院药学杂志， 2019 ， 39 （ 7 ）： 746 - 751 .

American Society of Health System Pharmacists . ASHP guidelines on compounding sterile preparations [J ] . Am J Health Syst Pharm ， 2014 ， 71 （ 2 ）： 145 - 166 .

MARTIN M . Basics of sterile compounding. Quality assurance and quality control：being prepared for U.S. Food and Drug Administration inspections and staying in compliance with United States pharmacopeia chapter：part 2 [J ] . Int J Pharm Compd ， 2018 ， 22 （ 6 ）： 475 - 478 .

Jr ALLEN L V . Basics of compounding for sterile，non- sterile，and quality control compounding：process analytical technology：appropriate for sterile and nonsterile compounding? [J ] . Int J Pharm Compd ， 2019 ， 23 （ 2 ）： 123 - 130 .

JEAN S J ， FRANCART S J ， ECKEL S F ， et al . Evaluation of telepharmacy and the use of a gravimetric technology-assisted workflow system for remote sterile product pharmacist checks [J ] . Am J Health Syst Pharm ， 2020 ， 77 （ 7 ）： 560 - 567 .

GUTHRIE S ， JENSEN T ， HARTLEY R C ， et al . Asses- sing the accuracy of intracameral phenylephrine preparation in cataract surgery [J ] . Eye ， 2018 ， 32 （ 10 ）： 1615 - 1620 .

TRISSEL L A . Pocket guide to the handbook on injectable drugs [M ] . 16 edition. Bethesda，MD ： American Society of Health-System Pharmacists ， 2011 ： 1 - 407 .

CHEN F C ， HE X D ， FANG B X ， et al . Simultaneous quantitative analysis of six proton-pump inhibitors with a single marker and evaluation of stability of investigated drugs in polypropylene syringes for continuous infusion use [J ] . Drug Des Devel Ther ， 2020 ， 14 ： 5689 - 5698 .

张倩楠，裴艺芳，盛雅莉，等 . 采用品管圈管理方法降低静脉用药集中调配中心调配药品差错率的研究 [J ] . 中国医院用药评价与分析， 2020 ， 20 （ 4 ）： 495 - 499 .

Views

572

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

⁰