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广西医科大学第一附属医院药学部,南宁 530021
副主任药师,硕士。研究方向:医院药学、药事管理。E-mail:125923075@qq.com
主任药师,硕士生导师,博士。研究方向:循证药学、数据挖掘与处理。E-mail:277749097@qq.com
收稿:2026-01-14,
修回:2026-05-11,
录用:2026-05-12,
纸质出版:2026-05-30
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谢旭华,伍云,黄松清,等.静脉制剂外配处方闭环管理模式构建与探索 Δ[J].中国药房,2026,37(10):1246-1250. DOI: 10.6039/j.issn.1001-0408.2026.10.02.
XIE Xuhua,WU Yun,HUANG Songqing,et al.Development and exploration of a closed-loop management model for externally dispensed intravenous prescriptions[J].ZHONGGUO YAOFANG,2026,37(10):1246-1250.
谢旭华,伍云,黄松清,等.静脉制剂外配处方闭环管理模式构建与探索 Δ[J].中国药房,2026,37(10):1246-1250. DOI: 10.6039/j.issn.1001-0408.2026.10.02. DOI:
XIE Xuhua,WU Yun,HUANG Songqing,et al.Development and exploration of a closed-loop management model for externally dispensed intravenous prescriptions[J].ZHONGGUO YAOFANG,2026,37(10):1246-1250. DOI: 10.6039/j.issn.1001-0408.2026.10.02.
目的
2
构建静脉制剂外配处方全流程闭环管理模式,为静脉制剂外配处方规范化管理提供参考。
方法
2
基于我院前期牵头制定的《静脉制剂外配处方闭环管理广西专家共识》,通过多学科团队头脑风暴法与鱼骨图框架,系统识别全流程风险点,制定并实施限定外配合作药店与药品目录、运维医院信息系统和静脉用药调配中心(PIVAS)智能管理平台、强化全链条人员差异化培训等策略,构建以PIVAS为核心枢纽、日间化疗中心为安全终端的全流程闭环管理体系。
结果
2
共遴选出3家合作药店及涵盖35个品规的首期药品目录,成功构建了涵盖医院门诊开药、患者药店购药、PIVAS配药和日间化疗中心用药四大模块的闭环管理流程,实现了静脉制剂外配处方与院内溶媒的强制关联成组、药品追溯码的全程核验、输注参数的智能监测与全流程数据追溯。
结论
2
所构建的模式有效解决了静脉外配药品从院外流转至院内使用的衔接与安全管控问题,初步实现了流程的标准化、信息的可追溯化与用药风险的主动防控。
OBJECTIVE
2
To construct a closed-loop management model for externally dispensed intravenous prescriptions, and to provide reference for standardized management of externally dispensed intravenous prescriptions.
METHODS
2
Based on the
Expert Consensus on Closed-loop Management of Externally Dispensed Intravenous Prescriptions in Guangxi Zhuang Autonomous Region
previously formulated by our hospital, risk points during the entire process were systematically identified through multidisciplinary team brainstorming and a fishbone diagram. A series of strategies were subsequently formulated and implemented, including qualifying designated external dispensing pharmacies and the drug catalogs, operating and maintaining the hospital information system and the Pharmacy Intravenous Admixture Service (PIVAS) intelligent management platform, and strengthening differentiated training for staff in the whole workflow. A whole-process closed-loop management system was constructed with PIVAS as the co
re hub and the daytime chemotherapy center as the safety terminal.
RESULTS
2
A total of 3 cooperating pharmacies and an initial drug list comprising 35 product specifications were selected. A closed‑loop management process encompassing hospital outpatient prescribing, patient drug purchase in designated pharmacies, PIVAS drug dispensing, and medication use in daytime chemotherapy center was successfully established. This system enabled the mandatory grouping and association of externally dispensed intravenous prescriptions with in-hospital diluents, full-process verification based on drug traceability codes, intelligent monitoring of infusion parameters, and whole-process data traceability.
CONCLUSIONS
2
The constructed model effectively resolves the coordination and safety oversight during the use of externally dispensed intravenous drugs from out-of-hospital circulation to in-hospital use, and has preliminarily enabled procedural standardization, whole-process information traceability, and proactive control of medication risks.
国家医保局 , 国家卫生健康委 . 国家医保局 国家卫生健康委关于建立完善国家医保谈判药品“双通道”管理机制的指导意见 [EB/OL ] . ( 2021-04-22 )[ 2025-08-01 ] . http://www.nhsa.gov.cn/art/2021/5/10/art_104_6527.html http://www.nhsa.gov.cn/art/2021/5/10/art_104_6527.html .
国家医疗保障局办公室 . 国家医疗保障局办公室关于进一步做好定点零售药店纳入门诊统筹管理的通知:医保办发 〔2024〕 4 号[EB/OL ] . ( 2023-02-15 )[ 2025-08-01 ] . https://www.gov.cn/zhengce/zhengceku/2023-02/16/content_5741663.htm https://www.gov.cn/zhengce/zhengceku/2023-02/16/content_5741663.htm .
国家医疗保障局办公室 . 国家医疗保障局办公室关于规范医保药品外配处方管理的通知:医保办函 〔2024〕 86 号[EB/OL ] . ( 2024-10-16 )[ 2025-08-01 ] . https://www.gov. cn/zhengce/zhengceku/202410/content_6980794.htm https://www.gov.cn/zhengce/zhengceku/202410/content_6980794.htm .
中国药师协会药学服务创新工作委员会 . 医疗机构处方药品外配与使用管理专家共识 [J ] . 医药导报 , 2025 , 44 ( 2 ): 169 - 175 .
阙富昌 , 罗道皇 , 彭丽芝 , 等 . 深圳市医疗机构住院患者外购药品闭环管理专家共识 [J ] . 中国药房 , 2025 , 36 ( 16 ): 1953 - 1957 .
曾铮 , 巫柳岑 , 路家旺 , 等 . 静脉制剂外配处方闭环管理广西专家共识 [J ] . 中国医院药学杂志 , 2025 , 45 ( 21 ): 2419 - 2425,2433 .
蒲强红 , 黄毅岚 , 刘易陇 , 等 . 四川省医疗机构药品追溯码全流程管理专家共识 [J ] . 中国药房 , 2025 , 36 ( 24 ): 3017 - 3022 .
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