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应用HFMEA法促进肝素钠注射液在儿童用药中的安全管理
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| 篇名： | 应用HFMEA法促进肝素钠注射液在儿童用药中的安全管理 |
| TITLE： | |
| 摘要： | 目的：促进肝素钠注射液在儿童用药中的安全使用。方法：应用医疗失效模式与效果分析法（HFMEA），通过文献检索、问卷调查、实地考察等方法，筛选肝素钠注射液在儿童用药过程中的失效模式，并针对这些失效模式制订防范策略并实施，再通过比较实施前、后差错率和风险优先级数（RPN）值评分评价实施效果。结果：通过RPN值评分共获得5项需立即干预的肝素钠注射液用药风险点，包括处方开具时肝素钠注射液给药剂量错误、药品调剂时药师不清楚肝素钠注射液用量的计算方法、护理给药时未执行输注前双人核对流程等。经制订并实施相应的防范策略后，肝素钠注射液相关差错由实施前的8例减少到1例，差错率由3.76％降低到0.51％（P＜0.01）；5项失效模式的RPN值分别由112.08、91.56、115.78、94.52、99.23下降到28.02、23.91、27.71、23.63、20.55。结论：应用HFMEA可前瞻性地对肝素钠注射液儿童用药环节进行系统的分析，再结合本院的实际情况制订并实施对应的防范策略后，可减少肝素钠注射液使用中的相关差错，促进儿童用药安全。 |
| ABSTRACT： | OBJECTIVE： To promote the safe use of Heparin sodium injection for children. METHODS： According to literature retrieve， questionnaire survey and field investigation， Health care failure mode and effect analysis method （HFMEA） was adopted to search for the failure modes of Heparin sodium injection for children， and preventive strategies were established and implemented based on these failure modes. Its effects were evaluated by comparing the error rate and risk priority number rating （RPN value） before and after the implementation. RESULTS： Totally 5 risk points of Heparin sodium injection requiring immediate intervention were obtained from RPN value， including wrong dose of Heparin sodium injection in prescribing， pharmacists’ unclearness for the calculation method of the dose of Heparin sodium injection in dispensing， and nurses’ no performing of double check system before infusion in administration， etc. After implementing related countermeasures， related error of Heparin sodium injection was decreased from 8 cases to 1 case， and error rate was declined from 3.76％ to 0.51％ （P＜0.01）. The RPN values of 5 failure modes were decreased from 112.08， 91.56， 115.78， 94.52， 99.23 to 28.02， 23.91， 27.71， 23.63， 20.55， respectively. CONCLUSIONS： HFMEA can prospectively conduct systematical analysis for Heparin sodium injection for children. Implementing related countermeasures based on the current situation of our hospital can reduce the related error of Heparin sodium injection and promote the medication safety of children. |
| 期刊： | 2017年第28卷第34期 |
| 作者： | 赵杰，张冠东，薛智民，杨钰，高燕飞，韩燕，赵瑞玲 |
| AUTHORS： | ZHAO Jie，ZHANG Guandong，XUE Zhimin，YANG Yu，GAO Yanfei，HAN Yan，ZHAO Ruiling |
| 关键字： | 肝素钠注射液；儿童患者；医疗失效模式与效果分析；用药安全 |
| KEYWORDS： | Heparin sodium injection； Children patients； Health care failure mode and effect analysis； Medication safety |
| 阅读数： | 312 次 |
| 本月下载数： | 7 次 |
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