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PIVAS药师在肠外营养审方系统优化及使用安全监护工作中的作用探索
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| 篇名： | PIVAS药师在肠外营养审方系统优化及使用安全监护工作中的作用探索 |
| TITLE： | Exploration of the role of PIVAS pharmacists in optimization of parenteral nutrition prescription systems and medication safety monitoring |
| 摘要： | 目的 为保障肠外营养液的处方、调配和使用安全，拓展静脉用药调配中心（PIVAS）药师的药学服务内容提供参考。方法我院PIVAS药师主导完善了PIVAS系统中肠外营养医嘱审核规则及肠外营养成品输液标签信息显示内容；加强了肠外营养液调配的过程管理，制定详细的调配过程质控巡查细则，并制作《肠外营养成品输液临床使用安全监护表》对肠外营养成品输液在使用过程中出现的成品输液异常、输注操作异常及并发症进行临床监护巡查。通过比较优化/巡查前后的肠外营养医嘱审核效率、不合理医嘱率、血管通路选择和滴注速度规范率、调配错误率和临床使用环节的异常情况数据考察上述优化/巡查措施的实施效果。结果优化后的审方系统实现了对肠外营养医嘱的自动审核，提高了医嘱审核效率，审核1条肠外营养医嘱的平均时长由原来的约1min变为10s；肠外营养医嘱不合理率较优化前下降了31.87%；肠外营养调配差错率较巡查前降低了56.55%；血管通路选择的规范率及滴注速度的规范率较标签信息优化前分别提高了13.29%和3.54%。PIVAS药师在抽查的298例使用肠外营养液的患者中发现了5例输注操作异常，并进行了及时干预。结论PIVAS药师通过优化审方系统，完善标签信息，加强调配环节和使用环节的质控巡查，保障了肠外营养成品输液的调配安全和使用安全，拓展了调剂药师药学服务的广度和深度。 |
| ABSTRACT： | OBJECTIVE To provide references for ensuring the safety of prescription preparation， dispensing， and use of parenteral nutrition solution， as well as for expanding the scope of pharmaceutical services provided by pharmacists in the Pharmacy Intravenous Admixture Services （PIVAS）. METHODS Under the guidance of PIVAS pharmacists， the rules for reviewing medical orders of parenteral nutrition in the PIVAS system and the information displayed on the infusion labels of finished parenteral nutrition solutions were refined. The process management of dispensing parenteral nutrition solution was strengthened， and detailed quality control and inspection rules were formulated. Additionally， Clinical Safety Monitoring Form for Finished Parenteral Nutrition Infusions was designed to conduct clinical monitoring and inspections for abnormalities in the finished infusions， infusion operations， and complications that may arise during the use of finished parenteral nutrition infusions. The implementation effects of the aforementioned optimization/inspection measures were evaluated by comparing data on the efficiency of medical order review for parenteral nutrition， the rate of irrational medical orders， the compliance rate of vascular access selection and infusion rate standardization， the rate of dispensing error， as well as the abnormalities occurring during clinical use， before and after the optimization/inspection initiatives were put into place. RESULTS The optimized prescription review system achieved automatic review of medical orders for parenteral nutrition， enhancing the efficiency of order review. The average time taken to review one parenteral nutrition medical order was reduced from approximately 1 minute to 10 seconds. The irrational rate of parenteral nutrition orders decreased by 31.87%. The dispensing error rate of parenteral nutrition decreased by 56.55%. The standard rate of vascular access selection and standard rate of infusion speed were increased by 13.29% and 3.54%， respectively. The PIVAS pharmacists identified and intervened in 5 abnormal cases out of 298 cases examined for use of parenteral nutrition solutions. CONCLUSIONS By optimizing the prescription review system， improving labeling information， and strengthening quality control inspections during both preparation and administration processes， PIVAS pharmacists have enhanced the safety of compounded parenteral nutrition solutions. This initiative has expanded the scope and depth of pharmaceutical care provided by dispensing pharmacists. |
| 期刊： | 2025年第36卷第11期 |
| 作者： | 豆兴茹；于迪；陈瑛；潘秀娟；孙怡；朱建国 |
| AUTHORS： | DOU Xingru，YU Di，CHEN Ying，PAN Xiujuan，SUN Yi，ZHU Jianguo |
| 关键字： | 肠外营养液；医嘱审核；用药安全；药学服务 |
| KEYWORDS： | parenteral nutrition solution； medical order review； safety of drug use； pharmaceutical care |
| 阅读数： | 16 次 |
| 本月下载数： | 1 次 |
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