摘要
目的 探究静配中心临床用药常见差错,提高静脉用药调配质量,确保用药安全可靠。方法 选取院内静配中心2021年1~12月工作流程中各环节出现的差错资料,对差错原因进行分析,并总结相关经验,制定防范措施。结果 我院静配中心2021年全年医嘱共计599 536条,各类差错共发现343起,差错率为0.057%,主要差错类型为:数量错误(29.74%)、贴签错误(15.16%)、漏拿(8.45%)、加药剂量错误(7.29%)、品规错误(6.41%)、归位错误(6.12%)等;引发差错的因素主要是:其他(选项不全或填写不规范57.14%)、习惯思维(15.45%)、状态不佳(10.50%)、处方辨认不清(6.41%)等;在出错时间段方面,下午的出错率明显高于上午,且多在贴签区(28.86%)、摆药区(27.99%)、二级库(18.66%)、混合调配区(16.03%)等环节产生。结论 通过制定完善的改进措施,使静配人员能够规范操作,加强责任意识,将差错降到最低,确保患者输液安全。
Objective To explore the common errors of clinical medication in intravenous dispensing center, improve the quality of intravenous medication dispensing, and ensure the safety and reliability of medication. Methods The error data of each link in the working process of the hospital static distribution center from January to December 2021 were selected, the causes of the error were analyzed, relevant experience was summarized, and preventive measures were formulated. Results There were 599 536 medical orders in 211 years in the static distribution center of our hospital, 343 errors were found, and the error rate was 0.057%. The main types of errors were as follows: Quantity error(29.74%), missing(15.74%), labeling error(15.16%), dosage error(7.29%), quality regulation error(6.41%), homing error(6.12%), etc. The main reasons for errors were: other(incomplete options or non-standard filling 57.14%), habitual thinking(15.45%), poor state(10.50%), unclear prescription(6.41%), etc.In terms of error time, the error rate in the afternoon was significantly higher than that in the morning, and most of the errors occurred in the drug dispensing area(27.99%), labeling area(25.36%), mixing area(16.03%) secondary library(18.66%) and other links. Conclusion By formulating perfect improvement measures, the static dispensing personnel can standardize the operation, strengthen the sense of responsibility, minimize the error, and ensure the safety of patients’ transfusion.
作者
张忠诚
林万龙
ZHANG Zhongcheng;LIN Wanlong(Department of Pharmacy,Women's and Children's Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital),Xiamen 361003,China)
出处
《中国医药指南》
2023年第2期72-75,共4页
Guide of China Medicine
关键词
静配中心
差错原因
差错类型
改进措施
Static distribution center
Cause of error
Error type
Improvement measures
