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PIVAS细胞毒性药物集中调配精细化管理模式的构建与应用
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| 篇名： | PIVAS细胞毒性药物集中调配精细化管理模式的构建与应用 |
| TITLE： | Establishment and application of a precise management model for the centralized preparation of cytotoxic drugs in PIVAS |
| 摘要： | 目的 构建静脉药物调配中心（PIVAS）细胞毒性药物集中调配精细化管理模式，并评价其应用效果。方法PIVAS药师基于信息闭环管理系统的数据反馈和药物配制后的稳定时限，通过征求临床意见和查阅细胞毒性药物集中调配相关资料，对细胞毒性药物调配全流程进行改进，构建了精细化管理模式。对比分析该模式实施前（2023年1－12月）和实施后（2024年1－12月）的调配时间、配送时间、成品输液配制后的放置时间、稳定时限内输注完成率等指标，评价该模式的应用效果。结果精细化管理模式的总体框架包括：审方系统功能升级、审方数据库的完善、PIVAS药师专项能力培训、药物配制动态批次决策管理、特殊药品管理、成品输液的配送管理、持续改进机制的建立。与实施前比较，该模式中每天上午配制任务较集中的第2、3批次细胞毒性药物平均调配时间显著短于实施前（P＜0.05）；实施后成品输液配送时间（[11.49±2.92）min]明显短于实施前（[22.11±5.03）min]（P＜0.001）；部分稳定时限较短的药物及联合方案中卡铂（紫杉醇或多西他赛+卡铂）的放置时间较实施前显著缩短（P＜0.05），在稳定时限内的输注完成率较实施前显著提高（P＜0.05）。结论我院成功构建了PIVAS细胞毒性药物集中调配精细化管理模式。该模式可使PIVAS每天上午时段各批次调配时间明显缩短，批次决策更为合理，成品稳定时限内输注完成率有所提升。 |
| ABSTRACT： | OBJECTIVE To establish the precise management model for the centralized preparation of cytotoxic drugs in pharmacy intravenous admixture services （PIVAS）， and evaluate the effects of its application. METHODS Pharmacists in PIVAS established the precise management model by soliciting clinical opinions and consulting literature on the centralized preparation of cytotoxic drugs and continuously refining every step of the preparation of cytotoxic drugs， based on data feedback from the information closed-loop management system and the limit of stability time of finished solutions. The indicators such as the preparation time， delivery time， the storage time of finished infusion solutions after preparation， and the completion rate of infusion within the stability time limit were analyzed before the implementation （January to December 2023） and after the implementation （January to December 2024） of this model， to evaluate its application effectiveness. RESULTS The overall framework for the precise management model included upgrading the functions of the prescription review system， improving the prescription review database， providing specialized training for PIVAS pharmacists， managing dynamic batch decision for drug preparation， managing special drugs， managing finished infusion distribution， and establishing a continuous improvement mechanism. Compared with before implementation， the average preparation time of the second and third batches of cytotoxic drugs with more concentrated morning preparation tasks in this model was significantly shorter than before implementation （P＜0.05）； the delivery time of finished infusion after implementation （[ 11.49±2.92） min] was significantly shorter than the delivery time before implementation （[ 22.11±5.03） min] （P＜0.001）； the storage time of some drugs with shorter stable time limit and carboplatin in combination regimens （paclitaxel or docetaxel+carboplatin） was significantly shortened compared to before implementation （P＜0.05）， and the completion rate of infusion within the stability time limit was significantly improved compared to before implementation （P＜0.05）. CONCLUSIONS Our hospital has successfully established a precise management model for the centralized preparation of cytotoxic drugs in PIVAS. This mode can significantly shorten the preparation time of each batch of PIVAS in the morning， make batch decisions more reasonable and improve the infusion completion rate within the stable time limit of the finished product. |
| 期刊： | 2025年第36卷第19期 |
| 作者： | 刘帅；李代毅；苏金环；谷尚军；牟宁波；周云莉；赖艳 |
| AUTHORS： | LIU Shuai，LI Daiyi，SU Jinhuan，GU Shangjun，MOU Ningbo，ZHOU Yunli，LAI Yan |
| 关键字： | 静脉药物调配中心；精细化管理模式；细胞毒性药物；联合化疗方案；动态批次决策；稳定时限 |
| KEYWORDS： | PIVAS； precise management model； |
| 阅读数： | 5 次 |
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