[1]李柯 姜德春 张培 李南 赵颖波 顾红燕.基于FMEA的PIVAS成品输液交接流程优化研究[J].中国卫生质量管理,2024,31(04):016-20.[doi:10.13912/j.cnki.chqm.2024.31.4.04]
　LI Ke,ZHANG Pei,LI Nan,et al.Optimization of Finished Products Infusion Handover Process in PIVAS Based on FMEA[J].Chinese Health Quality Management,2024,31(04):016-20.[doi:10.13912/j.cnki.chqm.2024.31.4.04]
点击复制

基于FMEA的PIVAS成品输液交接流程优化研究()
分享到：

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第31卷
期数:
2024年04期
页码:
016-20
栏目:
特别关注
出版日期:
2024-04-15

文章信息/Info

Title:
Optimization of Finished Products Infusion Handover Process in PIVAS Based on FMEA
作者:
李柯 姜德春 张培 李南 赵颖波 顾红燕
首都医科大学附属北京世纪坛医院
Author(s):
LI Ke; ZHANG Pei; LI Nan; et al
Beijing Shijitan Hospital,Capital Medical University
关键词:
失效模式与效应分析; 静脉用药调配中心; 成品输液; 医院感染
Keywords:
Failure Mode and Effect Analysis(FMEA); Pharmacy Intravenous Admixture Services(PIVAS); Finished Products Infusion; Nosocomial Infection
分类号:
R197
DOI:
10.13912/j.cnki.chqm.2024.31.4.04
文献标志码:
B
摘要:
目的对静脉用药调配中心（PIVAS）成品输液交接流程中医院感染风险管理机制进行分析，优化成品输液交接流程，降低医院感染传播风险。方法基于失效模式与效应分析(FMEA)对PIVAS成品输液交接流程中医院感染传播风险进行评估，选出高风险等级的失效模式，分析失效原因，制订改进措施，并对管理效果进行评价。结果在PIVAS成品输液交接流程中，共找出7个RPN＞125的风险点，从修订制度、人员管理、医院感染相关制度培训等方面进行改进。经过6个月的改进，7个高风险点RPN值均下降，药师与护士手卫生依从性分别增长36%和24%，护士取药时间从改善前的（20.0±8.9）min缩短至改善后的（14.0±8.4）min，取药时间缩短30%。结论应用FMEA对PIVAS成品输液交接流程中医院感染传播风险进行识别与评估，建立PIVAS成品输液交接医院感染传播风险管理机制，可及时发现流程中的高风险点，降低医院感染传播风险。
Abstract:
ObjectiveTo analyze the risk management mechanism of hospital infection in Pharmacy Intravenous Admixture Services (PIVAS) to optimize the handover process of finished product infusion,so as to reduce the risk of nosocomial infection transmission.MethodsBased on Failure Mode and Effect Analysis (FMEA), the risk of nosocomial infection transmission during transfusion handover of finished products in PIVAS was evaluated. Failure modes with high risk were selected, failure causes were analyzed, improvement measures were formulated, and management effects were evaluated.ResultsIn the handover process of finished PIVAS products, a total of 7 risk points with RPN > 125 were identified and rectified by revising the system, personnel management and training related to hospital infection system. After 6 months of improvement, the RPN values of 7 high-risk points decreased. Hand hygiene compliance among pharmacists and nurses increased by 36% and 24%, respectively. The time of taking medicine by nurses was shortened from 20.0±8.9 minutes before improvement to 14.0±8.4 minutes after improvement, and the time of taking medicine was shortened by 30%.Conclusion The FMEA was applied to identify and evaluate the risk of nosocomial infection transmission during the handover of finished products transfusion in PIVAS, and a nosocomial infection transmission risk management mechanism was established, which could timely detect high-risk points in the process and reduce the risk of nosocomial infection transmission.

参考文献/References:

［1］吴永佩, 颜 青, 张 健. 全国静脉用药集中调配工作模式与验收管理培训教材［M］.北京: 科学技术文献出版社, 2016：38. ［2］高山,许群芬,杨春松,等. 静配中心实施质量控制对医院感染的管控效果［J］.海峡药学,2022(1):226-228.［3］孙亚敏,刘锋,蔡伟,等. 北京市某市场新型冠状病毒肺炎相关聚集性疫情传播链分析［J］.中华流行病学杂志,2021,42(3):427-432.［4］何旗群.多重耐药菌医院感染的现状与护理防控进展［J］.中国医药指南,2018,16(16):42-45.［5］张怡湜,袁奕英,张洛彬，等.华南地区某综合医院肿瘤内科医院感染的回顾性队列研究［J］.实用医院临床杂志,2023,20(6):53-57.［6］YUAN ZZ,LI QQ,TANG TT,et al. Studies on the optimization of decontamination protocol for surfaces contaminated with cytotoxic drugs in PIVAS［J］.J Oncol Pharm Pract,2023,29(7):1565-1573.［7］范静,乔永洁,贾秀玲,等. 失效模式和效应分析在PIVAS全肠外营养液调配全流程风险管理的应用［J］.中国医院药学杂志,2020,40（17）:1881-1886. ［8］PINO FA，WEIDEMANN DK，SCHROEDER LL，et al．Failure modeand effects analysis to reduce risk of heparin use［J］.Am J Health－syst Pharm，2019，76（23）：1972-1979．［9］GAUR K.Systematic and quantitative assessment and application of FMEA and Lean six Sigma for reducing non productive time in operation theatre of a Tertiary Care Hospital in a metropolis［J］.Perioper Care Oper Room Manag,2019,16：100075．［10］张金凤，吴湘玉，刘玉洁，等. 应用FMEA降低消毒供应中心锐器伤风险［J］.中国卫生质量管理,2017,24(6):42-45. ［11］张汉玲. 我院保障PIVAS成品输液安全的实践［J］.继续医学教育,2019,33（11）:50-52.［12］袁海玲,武琼,王琳,等. 基于失效模式与效应分析法的PIVAS医院感染风险管理策略研究［J］.中国现代应用药学,2022，39(5):684-689.［13］王香人,吴琼,吴景楠. 常态化疫情防控背景下医护人员手卫生依从性的影响因素分析［J］.医学理论与实践,2023,36（1）:149-151.［14］闫丽,满招娣,孔庆芳,等. 某医院物体表面和工作人员手卫生现状调查［J］.中国消毒学杂志,2023,40（1）:33-34，38.［15］国家卫生健康委.静脉用药调配中心建设与管理指南（试行）［EB/OL］.（2021-12-10）［2023-08-01］.http://www.gov.cn/zhengce/zhengceku/2021-12/21/content_5663666.htm.［16］王守涛,贾超,朱琳. 医院PIVAS洁净区环境监测标准探讨［J］.中国药房,2017,28(7):1006-1008.［17］邱妮娜,武夏明,肖玉良，等.应用失效模式与影响分析方法降低PIVAS危害药品调配中的职业暴露风险［J］.中国药房,2018,29(14):1873-1876.［18］吴文女,朱立苇,陈峰，等.血液成分制备自动化设备的消毒方法及效果监测［J］.中国消毒学杂志,2022,39(7):497-499.

相似文献/References:

[1]张金凤 吴湘玉 刘玉洁 许瑛 何军荣.应用FMEA降低消毒供应中心锐器伤风险[J].中国卫生质量管理,2017,24(06):042.[doi:10.13912/j.cnki.chqm.2017.24.6.15]
[2]李希西 邓兰兰 王海燕 何芳 邱云.风险管理理论在护理应急管理中的应用[J].中国卫生质量管理,2019,26(04):070.[doi:10.13912/j.cnki.chqm.2019.26.4.20]
[3]盛哈蕾 姜露 陈锦 张克斌 柏杨 高家蓉 杨自豪 陈浩 廖路.FMEA在科研实验室危险化学品管理中的应用[J].中国卫生质量管理,2019,26(05):010.[doi:10.13912/j.cnki.chqm.2019.26.5.05]
[4]何梅王东*鲜于剑波蒋涛杨培杜小波石波陈忠伦王海燕 陈湘马春华喻明成.失效模式与效应分析在新冠肺炎疫情防控中的应用探讨[J].中国卫生质量管理,2020,27(04):027.
　HE Mei,WANG Dong,XIAN Yujianbo,et al.Application of Failure Mode and Effect Analysis in Epidemic Prevention and Control of 2019 Novel Coronavirus Pneumonia[J].Chinese Health Quality Management,2020,27(04):027.
[5]张圣宏 宋毅 张红花 晏晨阳.新冠肺炎疫情防控期间针灸门诊风险管理策略研究[J].中国卫生质量管理,2021,28(03):033.[doi:10.13912/j.cnki.chqm.2021.28.3.11 ]
　ZHANG Shenghong,SONG Yi,ZHANG Honghua.Risk Management Strategy of Acupuncture Outpatient during COVID-19 Epidemic Prevention and Control Period[J].Chinese Health Quality Management,2021,28(04):033.[doi:10.13912/j.cnki.chqm.2021.28.3.11 ]
[6]吕红梅 府裕琦 陈熙 孙路路.PIVAS运行对静脉用药集中调配管理专业组影响的调查分析[J].中国卫生质量管理,2024,31(04):021.[doi:10.13912/j.cnki.chqm.2024.31.4.05]
　LV Hongmei,FU Yuqi,CHEN Xi,et al.Investigation and Analysis of the Influence of PIVAS Operation on the Pharmacy Intravenous Admixture Service Professional Group[J].Chinese Health Quality Management,2024,31(04):021.[doi:10.13912/j.cnki.chqm.2024.31.4.05]

更新日期/Last Update: 2024-04-15