摘要
目的基于医疗失效模式与效应分析(HFMEA)建立危害药品给药过程防护流程,提升医护人员及相关人员的安全防护水平。方法参考HFMEA方法,对现有的危害药品给药各环节进行危害程度评估,分析原因并提出改善方法。项目改善期间为2016年3月至7月,从危害药品给药各个环节流程中找出29项失效模式和20项失效原因,最后拟出14项失效模式与合并归纳缺乏危害药品验收入库及贮存防护流程、院内对医嘱开立未有明确分级管理制度以及缺乏该类药物摆药贴签核对管理规定等9项失效原因进行改善。通过要求供货商使用专用配送箱单独配送并明确标识,验收时佩戴双层口罩、手套、设立专柜单独贮存并有警示标志以及汇总数据写报告,交予药学部,向医务部提出申请分级管理等改善对策。结果改善对策实施后(2016年8月1日至12月31日),危害药品(静脉滴注类)集中调配率为100%,较改善前(2016年3月至7月)提高20%;各环节防护流程执行率为98%,较改善前(2016年3月至7月)提高78%,未出现危害药品给药过程的职业暴露事件。建立防护流程后,持续改进小组对失效模式又进行了一次危害程度评估,结果危害程度平均分由改善前的14分降至改善后的1分,效果明显。结论运用HFMEA方法,采取前瞻性风险评估,建立危害药品给药过程的防护流程,有效提高了危害药品的集中调配比例,医护人员安全防护意识大大提高,各环节防护流程执行率也随之提升,医护人员与相关人员的安全防护水平进一步提升。
Objective To establish the protection process of harmful drug based on healthcare failure mode and effect analysis(HFMEA),in order to improve the safety and protection level of medical staffs and related personnels.Methods According to the HFMEA method,the damage degree of the existing drug delivery process was evaluated,the reasons were analyzed and the improvement methods were put forward.The duration of the project was from March to July in2016,29failure modes and20failure reasons were found out in the drug delivery process.At last,14failure modes and9failure reasons(such as lack of protection process of acceptance and storage of harmful drug,no clear hierarchical management system for medical orders in the hospital,lack of administrative regulations to check the dispensing and labeling of the drugs)were drawn up.The suppliers were required to use special distribution boxes to distribute and identify them separately.At the time of acceptance,we should wear double-layer masks,gloves,set up separate counters with store warning signs and collect data,write reports,submit them to the pharmacy department,and put forward the improvement measures for the medical department to apply for classification management.Results After the implementation of the countermeasures(from August1st to December31st in2016),the centralized allocation rate of harmful drug(intravenous drip)was100%,which was increased by20%compared with before the improvement(from March to July in2016).The implementation rate of the protection process of each link was98%,which was increased by20%compared with before the improvement(from March to July in2016).No occupational exposure events were occurred in the process of using harmful drug.After establishing the protection process,the continuous improvement team carried out an evaluation of the damage degree to the failure mode,the result showed that the average degree of damage changed from14points before improvement to1point after improvement.The effect was obvious.Conclusion The protective process for h
作者
常惠礼
林杰茹
Chang Huili;Lin Jieru(Department of Pharmacy, The Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan,Guangdong, China 511500)
出处
《中国药业》
CAS
2017年第24期88-92,共5页
China Pharmaceuticals
关键词
医疗失效模式与效应分析
危害药品
给药过程防护
healthcare failure mode and effect ananlysis
harmful drug
protection of drug delivery process
