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OBJECTIVE To calculate the cost of centralized dispensing of four categories of drugs （ordinary drugs， antibacterial drugs， hazardous drugs， and parenteral nutrition solutions） in pharmacy intravenous admixture service （PIVAS）， and provide reference for setting charging standards for relevant departments. METHODS The operating costs of PIVAS in 12 medical institutions from Shaanxi province were collected through questionnaire survey， including labor costs， medical and health material costs， fixed asset depreciation and repair costs， water and electricity costs， and management costs. The operation time allocation coefficient method and workload allocation coefficient method were comprehensively used to allocate the above costs， and the unit preparation costs of four categories of drugs were calculated. RESULTS The average annual total costs of dispensing ordinary drugs， antibacterial drugs， hazardous drugs， and parenteral nutrition solutions in Shaanxi province were （2 195 900.25±1 680 893.73） yuan， （746 341.59±725 839.39） yuan， （331 420.15±183 258.83） yuan， and （330 322.68±277 281.70） yuan， respectively， with labor costs accounting for the highest proportion， averaging 85.49%. The costs of dispensing a set of ordinary drugs， antibacterial drugs， and hazardous drugs were 5.89， 7.60， and 14.37 yuan， respectively； the cost of dispensing one bag of parenteral nutrition solution was 32.15 yuan （excluding the cost of disposable intravenous nutrition bags）. CONCLUSIONS The cost calculation method and data of different types of intravenous drugs obtained in this study can provide reference for relevant departments to formulate and adjust PIVAS fee standards.
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OBJECTIVE To calculate the cost of centralized dispensing of four categories of drugs （ordinary drugs， antibacterial drugs， hazardous drugs， and parenteral nutrition solutions） in pharmacy intravenous admixture service （PIVAS）， and provide reference for setting charging standards for relevant departments. METHODS The operating costs of PIVAS in 12 medical institutions from Shaanxi province were collected through questionnaire survey， including labor costs， medical and health material costs， fixed asset depreciation and repair costs， water and electricity costs， and management costs. The operation time allocation coefficient method and workload allocation coefficient method were comprehensively used to allocate the above costs， and the unit preparation costs of four categories of drugs were calculated. RESULTS The average annual total costs of dispensing ordinary drugs， antibacterial drugs， hazardous drugs， and parenteral nutrition solutions in Shaanxi province were （2 195 900.25±1 680 893.73） yuan， （746 341.59±725 839.39） yuan， （331 420.15±183 258.83） yuan， and （330 322.68±277 281.70） yuan， respectively， with labor costs accounting for the highest proportion， averaging 85.49%. The costs of dispensing a set of ordinary drugs， antibacterial drugs， and hazardous drugs were 5.89， 7.60， and 14.37 yuan， respectively； the cost of dispensing one bag of parenteral nutrition solution was 32.15 yuan （excluding the cost of disposable intravenous nutrition bags）. CONCLUSIONS The cost calculation method and data of different types of intravenous drugs obtained in this study can provide reference for relevant departments to formulate and adjust PIVAS fee standards.
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The traditional intravenous infusion configuration in medical institutions has the shortcomings of long time and low efficiency， and it is difficult to ensure that the dispensed liquid medicine is not contaminated. At the same time， medical staff may be exposed to risks such as cytotoxic drugs due to lack of protection. To solve the defects and deficiencies in intravenous infusion configuration， the “Dolphin 7” pharmacy intravenous compounding robots are introduced in our hospital， cluster management platform is constructed based on data middle platform service exchange system； mini-intelligent PIVAS module is designed and constructed. The mode can reduce the workload of medical staff， save medical construction and labor costs， also help to promote and deepen the construction of intelligent hospitals.
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Objective To establish a rational drug use model of PIVAS and promote the rational drug use in clinical practices by enhancing the quality of prescription review by pharmacists. Methods The PIVAS physician orders received from 2014 to 2021 were extracted through the hospital information management (HIS) system. The types of irrational physician orders were statistically analyzed, the improvements were made by the method of quality control circle (QCC). Results The model of PIVAS rational drug use formed a standardized process. The proficiency of physician order review was improved. From 2014 to 2021, the number and proportion of unreasonable physician orders in PIVAS decreased year by year. Every type of unreasonable physician orders was improved year by year. Conclusion The professional and technical levels of pharmacist for physician order review at our hospital were improved by the model of PIVAS rational drug use. The quality of pharmaceutical service was significantly improved which ensured the safety of patients' medication.
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OBJECTIVE：To explore the new management model of Good Clinical Practice （GCP）trial drug dispensing . METHODS：Base on the relevant experience of Pharmacy Intravenous Admixture Services （PIVAS）in daytime chemotherapy center（“daytime PIVAS ”for short ）of our hospital ，the nodes and other matters needing attention were discussed in the workflow of confirmation and development of drug dispensing tasks for clinical trials. RESULTS ：After the successful approval of the new clinical trial ，the supervisor of the sponsor and the principal investigator should first confirm whether the drugs involved in the project needed to be centrally dispensed in the daytime PIVAS ，and then submitted the relevant data to PIVAS for filing. Daytime PIVAS pharmacists could participate in trial drug dispensing of relevant projects only after starting training and authorization. After the doctor issued the medical order for the subjects in the hospital information system ，the research nurse took the drugs out of the GCP pharmacy and handed them to the daytime PIVAS drug receiving window. After receiving the drugs ，the pharmacist would check the dispensing ，and then the preparation pharmacist trained and authorized by the project team would mix and dispense the drugs. The reviewed pharmacist would check and label the prepared infusion. In addition ，daytime PIVAS would regularly summarize the feedback information on the trial drug dispensing and fund management in all links of dispensing process ，so as to improve the standardization of the process. CONCLUSIONS ：Daytime PIVAS for clinical trial drug can arrange batches more rationally，ensure smooth and orderly infusion ，and meet different drug stability requirements ，which can improve trial drug dispensing management and further promote the development of drug clinical trial projects in China.
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OBJECTIVE：To pro vide reference for promoting the standardized construction of centralized intravenous drug dispensing mode and the healthy development of PIVAS and improving the rational infusion in China. METHODS ：The establishment and development process of PIVAS in China were reviewed ，the necessity ，current situation and problems to be solved of centralized intravenous drug dispensing mode were analyzed. RESULTS & CONCLUSIONS ：Due to scientific ， advanced，smooth，convenient operation procedure and standardized management ，and reduced occupation exposure ，centralized intravenous drug dispensing mode ，of which the pharmacists were in charge ，had become the inevitable development direction of intravenous drug dispensing in Chinese hospitals. The overall PIVAS construction in China had worked well and played a significant role，not only significantly improved the quality of finished infusion ，promoted rational drug use ，protected the health of nurses and ward （area） environment，but also contributed to the construction and development of the nursing profession ，and also contributed to the improvement of the pharmacy department ’s own management level. However ，the value of PIVAS pharmacist service still needs to be understood.
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OBJECTIVE: To investigate the use of PDCA mode for risk assessment and risk management of pharmacy intravenous admixture service. METHODS: A retrospective analysis was made on the errors recorded in the intravenous drug dispensing center from Monday 2019 to March 2019. The types and links of errors were counted and classified, and the causes were analyzed. Targeted preventive measures were implemented from April to June 2019 to observe the incidence of errors before and after prevention in intravenous drug dispensing centers. RESULTS: Through the PDCA cycle management intervention, the main errors in intravenous drug dispensing center are dispensing, labeling, reviewing, checking and issuing. The incidence of errors in each link after prevention is lower than that before prevention, and the difference is statistically significant (P<0.001). CONCLUSION: The PDCA cycle management and risk assessment are conducted. The paper analyzes the types and causes of common errors in intravenous drug dispensing center, so as to formulate corresponding preventive measures, which can reduce the risk factors of errors, reduce the incidence of errors, improve the quality of finished product infusion and the safety of intravenous drug use.
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OBJECTIVE：To investigate the status quo and influential factors for scientific research training of pharmacists （nurses）in PIVAS of China ，to provide direction and reference for the development of PIVAS. METHODS ：The survey method was used to conduct a questionnaire survey of PIVAS pharmacist （nurses）from 29 tertiary and secondary hospitals in 24 provinces， autonomous regions ， municipalities from eastern ， western and central China through the i nternet by using self-designed questionnaire. The survey period was from Mar. to Apr. 2019. The survey content included the basic information （gender，region， hospital level ，professional and technical title ，education background ，employment nature ）of the survey participants and the status quo of scientific research training （frequency and content of scientific research training ，degree of need for scientific research ， degree of interest in scientific research ，etc.）and status quo of scientific research output （publication and application of the project）. Main influential factors for scientific research training were analyzed. RESULTS ：A total of 504 questionnaires were sent out，and 501 valid questionnaires were collected ，with effective response rate of 99.40％ . Totally 63.1％（316/501）of the respondents had scientific training ，and the frequency of scientific training was mainly less than one time/month （26.1％，131/501） and 1-2 times/month（25.0％，125/501）；72.1％（361/501）of the respondents have medium or above scientific research needs ， 82.4％（413/501）of the respondents have medium or above interest in scientific research ，only 6.0％（30/501）of the respondents had mastered the major scientific research methods ， only 5.4％（27/501）of the respondents thought that their scientific research ability were strong. The pharmaceutical re search - direction was mainly related to clinical rational use of drugs ， song_123@126.com less to precision medicine ，new drug and new dosage form： development， therapeutic drug monitoring research ， 028-85503220。E-mail：linyunzhu99@163.com translational medicine ， etc. Only 16.6％ （83/501） of the respondents had published articles after working in PIVAS ，and 9.0％（45/501）had applied for projects. There were statistical significances in the scientific research training among the respondents with different regions ，professional and technical titles ， educational backgrounds and employment natures （P＜0.05）. CONCLUSIONS ：The scientific research training of PIVAS pharmacist（nurses）in China is inadequate and the research output is low. Main influential factors for scientific research training include region ，professional and technical title ，educational background and employment nature .
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OBJECTIVE：To introduce the development and application of automatic dosing and mixing system of intravenous infusion in PIVAS of our hospital. METHODS ：Based on the bar code management system in PIVAS ，combined with automatic mixing equipment ，our hospital developed and designed automatic dosing and mixing system of intravenous infusion which could realize real-time scanning and charging of drugs ，setting parameters of mixed dispensing and automatic dosing and mixed dispensing of intravenous infusion. Compared with manual dispensing model ，work efficiency of 5 staff who dispensed Coenzyme complex for injection and Carbazochrome sodium s ulfonate for injection 300 bags each as well as the amount of drug residues in empty bottle were investigated to evaluate the effects of the system. RESULTS ：The system realized automatic mixing of intravenous infusion. In manual dispensing model and automatic dispensing model ，the mixing efficiency of Coenzyme complex for injection were （96.6±10.0）and（195.2±10.7）bag/h（P＜0.001）；mixing efficiency of Carbazochrome sodium sulfonate for injection were （83.8±12.9）and（118.8±6.7）bag/h（P＜0.001）. The amount of residual liquid in Coenzyme complex for injection empty bottle were （0.09±0.02）and（0.11±0.01）mL；Carbazochrome sodium sulfonate for injection empty bottle were （0.08± 0.02）and（0.12±0.01）mL，which were all lower than the internal control requirements that injected solvent volume was no more than 5％ （0.15 mL）. CONCLUSIONS ：The automatic dosing and mixing system of intravenous infusion could improve the efficiency of intravenous infusion dispensing and reduce the labor intensity of the staff .
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ABSTRACT OBJECTIVE：To establish the infusion sequence regulation procedure of PIVAS，and implement individual regulation. METHODS：By combining factors such as liquid volume of each batch，incompatibility between groups and specific solvents of specific drugs，intelligent prompt system and the artificial intelligent regulation system of infusion sequence were successively established to sequence the therapeutic drugs and adjuvant drugs used for the patients with different diagnoses and different purposes in different inpatient areas in a day，so as to realize intelligent control of individual infusion sequence. From Jan. to Sept. in 2017 and from Jan. to Sept. in 2019 as research stages before and after the intelligent control of individualized infusion sequence，the control effect was evaluated with the proportion of reasonable number of infusion priority cases，the proportion of appropriate number of elderly patients’batch liquid volume cases，the proportion of incompatibility cases between separate groups， the number and cost of flushing tubes as index. RESULTS：After regulating infusion sequence individually，the proportion of reasonable infusion priority rose from 5.56％ to 98.72％ ；the proportion of batch liquid quantity appropriate cases in elderly patients rose from 9.58％ to 98.10％；the proportion which separated the incompatibility between groups rose from 41.03％ to 99.12％；the number of washing tube dropped to（0.95±0.43）times/ward/d from（12.95±0.57）times/ward/d；the cost of washing tube could be saved 85 800 yuan/year. CONCLUSIONS：The implementation of individualized infusion sequence regulation promote safe and effective infusion，and provide reference for pharmacists of PIVAS in China to carry out precise pharmaceutical care.
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OBJECTIVE：To explore the key factors affecting the sustainable development of pharmacy intravenous admixture service（PIVAS），and to provide theoretical basis for the healthy development of PIVAS. METHODS ：Retrieved from PubMed ， CNKI，Wanfang database and VIP ，literatures related to the development of PIVAS. Combining with the actual operation and development of PIVAS in China in recent 20 years，based on actual experience of PIVAS in our hospital in recent 10 years，the key factors affecting the sustainable development of PIVAS were analyzed by retrospective method from five aspects ，i.e. drug management，quality control ，pharmacists’professional quality improvement ，pharmaceutical care extension ，cost and benefit. RESULTS & CONCLUSIONS ：The key elements of PIVAS drug management included drug inventory ，expiration date ，daily inventory，high-warning drug ，drug damage ，slack demand of drug and drug shortage. The key elements of PIVAS quality control included personnel quality control ，environment quality control and quality control of finished infusion. Improving the professional ability and communication service ability of pharmacists were the key factors to improve the professional quality of pharmacists. The establishment and application of medication order review and accurate flushing database based on PIVAS prescription audit system，professional drug consultation and clinical education ，whole pharmaceutical care of cytotoxic drugs and PIVAS adverse drug reaction monitoring were the key elements of pharmaceutical service extension. It can promote the sustainable and healthy development of PIVAS to improve pharmacists ’professional ability and communication ability ，strictly drug management and quality control ，continously extend pharmaceutical care ，improve professional influence and expand social influence and formulate reasonable charging mechanism.
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OBJECTIVE：To standardize and optim ize the clinical use of Trastuzumab for injection ，and to provide reference for rational use of drugs in the patients. METHODS ：The pharmacy intravenous admixture service （PIVAS）in our hospital took the lead in communication and coordination with financial ，information，medical insurance departments as well as clinicians and nurses，to set up dispensing ，charging and reimbursement mode by dose of trastuzumab. Under that ，doctors could give orders according to the clinical dosage of patients ；PIVAS dispenses drugs according to the actual dose ；the drugs were shared among patients；the charge and reimbursement of drugs are carried out according to the actual dose of patients. At the same time ，the questionnaire survey was conducted among 60 patients about the medical experience and cost savings before and after the implementation of the mode . RESULTS ：The questionnaire survey showed that in terms of solving the potential safety problems of trastuzumab and the inconvenience of patients ’medical treatment ，the solution rate of the mode was 100％；in terms of improving patients’feeling of seeking medical treatment and helping treatment ，the improvement rate was 100％；in terms of saving patients ’ treatment costs ，most（80％）of the patients thought that it could save less than 500 yuan each time ，and rest of the patients thought that it could save more than 500 yuan each time. CONCLUSIONS ：The mode of dispensing ，charging and reimbursement of Trastuzumab for injection in our hospital has solved the problems of drug waste ，occupational injury and inconvenient preservation in clinical use ，and has played a good role in drug safety ，cost saving and patient convenience.
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OBJECTIVE： To systematically evaluate the mode of personnel training in pharmacy intravenous admixture services （PIVAS） in China， and to provide reference for the comprehensive training of pharmacist in PIVAS in China. METHODS： PubMed， Embase， Cochrane Library， CBM， CJFD， VIP and Wanfang database were searched from the establishment of database to Sept. 2018. Studies which evaluated the training mode of PIVAS in China were included， and the results were presented by descriptive analysis in respects of training objects， training objectives， contents and evaluation indicators. RESULTS： A total of 5 literatures were included. The research types were 2 before-after control studies， 2 experience sharing studies and 1 review. 3 subjects were pharmacists， 1 subject was clinical pharmacists， and 1 subject was nurses. The training objectives were comprehensive quality training， clinical rational drug use level， pharmacy personnel training path and professional service ability. The specific training content of the training mode varied greatly， including professional theoretical knowledge， practical operation ability， pre-job training， professional psychological quality， professional ethics and laws and regulations， continuing education learning ability， career development planning and teaching ability. There were great differences in the evaluation indicators of training effectiveness， which were mainly reflected in team execution motivation and creativity， discoveny rate of unreasonable doctor’s advice， work efficiency， service quality， drug treatment level and satisfaction of PIVAS， etc. CONCLUSIONS： There are certain differences in the training objectives， training targets， specific contents and evaluation indicators of the PIVAS pharmacist training model in China. It is necessary to use the evidence- based method to construct the training mode for PIVAS pharmacist to provide support for clinical intravenous drug use.
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Objective To evaluate the application effect of meticulous management mode on prevention and control of infection related to pharmacy intravenous admixture service(PIVAS). Methods Qualified detection results of hygiene status of object surface,air culture quality,hand hygiene of medical staff in PIVAS in a hospital from Janu-ary 2014 to December 2016 were investigated,meticulous management measures were taken to intervene and analyze the detection results.Results The qualified rates of hand hygiene in 2014-2016 were 68.18%,81.82%,and 100.00% respectively,hand hygiene qualified rates in different years were statistically different(χ2=2.993,P=0.019). Qualified detection rates of surface of small objects,surface of horizontal laminar flow hoods,surface of biosafety cabinets,and air quality of dressing room Ⅰ and Ⅱ in PIVAS all increased to 100% in 2016.Conclusion Strengthening meticulous management of the internal work of PIVAS can effectively improve staff's standardized operation.
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OBJECTIVE; To improve the PIVAS quality management, reduce dispensing error and promote the safety of drug use.METHODS: The quality control circle (QCC) was used for quality management in PIVAS of our hospital. The reasons for dispensing errors were analyzed to determine the key improvement points using "the reduction of dispensing error of admixture drugs" as theme. Improvement plan was formulated, and effective countermeasures were determined by PDCA (Plan, Do, Check, Action) cycle management. The tangible results (the rate of dispensing errors) and intangible results were compared before (Feb. 2016) and after QCC (Aug. 2016). RESULTS: Some effective measures were formulated and implemented, including unified arrangement, introducing PIVAS MATE process management software, personnel post training, refining drug withdrawal management, visual management, etc. The tangible results included the rate of dispensing error decreased from 1. 81‰ to 0. 53‰; the rate of goal achievement reached 108. 47％; the rate of target progress was 70. 72％. The intangible results included optimizing drug dispensing process, standardizing drug withdrawal systent and personal training system. Those achievement improved confidence, responsibility, sense of cooperation and cohesiveness of QCC members. Additional result was obtained, i. e. utility model patent for avoiding light storage box. CONCLUSIONS: QCC can effectively improve the management quality of PIVAS workflow and the safety of intravenous medication.
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OBJECTIVE:To provide reference for confirming the protective effect of the establishment of PIVAS on antineoplastic drugs(ADs)occupational exposure to nursing staff in clinical departments,and to provide the basis for the formulation of ADs dispensing guideline and occupational exposure protection regulations. METHODS:By questionnaire survey and deriving data of lab examination index,the occurrence of abnormal menstruation,bad birth outcome,alopecia,blood toxicity, liver and renal toxicity in nursing staff of clinical departments with different ADs contact frequencies(non-exposure group as group A,low-exposure group as group B,high-exposure group as group C)were investigated and analyzed in our hospital before and after the establishment of PIVAS. The residual of ADs [methotrexate(MTX)and 5-Fluorouracil(5-FU)] in PIVAS environment were investigated by HPLC. RESULTS:A total of 160 questionnaires were sent out before the establishment of PIVAS,and 151 were effectively collected with effective recovery of 94.38%. After the establishment of PIVAS,150 questionnaires were sent out,and 144 were effectively collected with effective recovery of 96.00%. Questionnaire results showed that the incidence of abnormal menstruation,abnormal menstruation period,dysmenorrhea,spontaneous abortion,infertility and offspring low birth weight,the severity of hair loss in group C were significantly higher than group A,with statistical significance(P<0.05 or P<0.01). The incidence of above 6 conditions in group C were 5.14,6.10,3.81,4.04,6.15,8.08 times higher than in group A.At same time, the incidence of the offspring low birth weight and the severity of hair loss in group B were significantly higher than group A,with statistical significance(P<0.05 or P<0.01);the incidence of the former in group B was 6.21 times higher than in group A.After the establishment of PIVAS,the incidence of abnormal menstruation,abnormal menstruation period,dysmenorrhea,spontaneous abortion,infertility and offspring low birth weight,the severity of hair loss were decreased significantly in group C,with statistical significance(P<0.05). The severity of hair loss in group C was significantly higher than group A,and there was no statistical significance in above indexes,compared with group A(P>0.05). At the same time,there was no statistical significance in the incidence of the offspring low birth weight and the severity of hair loss between group B and A(P>0.05). Results of lab examination index investigation showed that before the establishment of PIVAS,WBC and PLT of group C were significantly lower than group A,and the incidence of abnormal liver function was significantly higher than group A,with statistical significance(P<0.05 or P<0.01). After the establishment PIVAS,WBC,PLT and RBC of group C,and PLT of group B were increased significantly compared to before the establishment PIVAS;the incidence of abnormal liver function in group C was decreased significantly compared to before the establishment PIVAS,with statistical significance(P<0.05 or P<0.01). There was no statistical significance in above indexes between group C and A(P>0.05),and PLT of group B was even significantly higher than group A(P<0.05). Results of investigation of ADs residues in PIVAS environment showed that there were different degrees of MTX and 5-FU residue on the surface of different objects. The residues of ADs from high to low were biological safety cabinet worktops,the floor just below biological safety cabinet,transfer box,transfer window and door handle and infusion bags. CONCLUSIONS:Nursing staff of clinical department with high ADs contact frequency face higher relevant health risks. The establishment of PIVAS can effectively protect the ADs occupational exposure of nursing staff in clinical departments,thereby reducing the above risks.At the same time,there are still different degrees of ADs residues on the surface of different objects in the PIVAS environment,and transshipment out of PIVAS is possible. It is suggested that the awareness of protection against occupational exposure risk caused by ADs residues in PIVAS environment should be improved;unified guideline for ADs dispensing and occupational exposure protection regulations should be formulated as soon as possible,so as to reduce occupational exposure risk associated with ADs for nursing staff in PIVAS and clinical departments.
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Objective: The construct a pharmacy intravenous admixture service (PIVAS) for changing configuration of intravenous drugs from decentralized configuration to centralized allocation supply so as to guarantee the safety of clinical drugs of hospital. Methods: Through constructed PIVAS, adopted purified air-condition system and established fluid-layers room of different grade to achieve sterile environment for configuration of intravenous drugs. And the centralized allocation should be implemented as the characteristics of different drugs. Results: The PIVAS could reduce the waste of drugs and decrease their cost. At the same time, it guaranteed the safety of clinical medication of hospital on the bases of enhancing work efficiency of clinical nurse and reasonably resolving allocation of human resources. Conclusion: The PIVAS that changes the configuration of intravenous drugs from decentralized configuration to centralized allocation supply can positively and effectively promote the safety of clinical medication and increase work efficiency of nursing and care.
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OBJECTIVE:To provide reference for the establishment and improvement of work system for clinical pharmacist in PIVAS of our province even the country. METHODS:Questionnaire was conducted to investigate the PIVAS directors in the 65 third-grade class A hospitals in China,and the data was statistically analyzed. RESULTS:Totally 65 questionnaires were sent out, 63 were effectively received,with effective rate of 96.9%. 98.4% respondents thought PIVAS should equip clinical pharmacist,but the actual situation in respondent's hospital was not ideal. 100% thought clinical pharmacist in PIVAS should have the ability of prescription checking and prescription evaluation;more than 95% thought clinical pharmacist in PIVAS should assume the medi-cine publicity and education and need to have good communication with clinic;only 42.9% thought clinical pharmacist in PIVAS need to take part in the routine drug dispensing. CONCLUSIONS:It is necessary to equip clinical pharmacist with professional training in PIVAS. Clinical pharmacist in PIVAS should focus their ability on prescription checking and evaluation,medicine public-ity and education,communication with clinic.
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OBJECTIVE:To provide reference for reducing the clinical return of finished infusions. METHODS:Interventions for clinical return of PIVAS finished infusions in our hospital were introduced,the return situation of finished infusions before(dur-ing 2013-2014)and after(during 2015-2016)intervention was compared,and intervention effects were evaluated. RESULTS:Our hospital intervened it by rationally selecting and using syringes,strengthening visible particle check of finished infusion before dis-tribution;optimizing the order of drug configuration,reasonably arranging the drug infusion sequence;strengthening the clean-up in work area before drug infusion,correctly using disinfectant;strictly implementing intravenous infusion associative operation, playing the role of pharmacists;cultivating good work habits,and strengthening teamwork,etc. Compared with before interven-tion,the return numbers of finished infusion were decreased by 41.2%,and reported loss amount reduced by 45.7%. The return caused by visibility particles,finished infusion oxidation discoloration after too long storage time,finished infusion leakage,contin-uous infusion of drugs compatibility,heterodyne error,improper drug configuration method in packaging to the ward,improper use of disinfectant before infusion decreased by 25.3%,46.9%,39.4%,77.8%,73.9%,75.0%,100%,respectively. CONCLU-SIONS:Intervening the return of finished infusion can reduce the return numbers and drug waste.
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OBJECTIVE:To evaluate the control efficacy of details thinking management on the infusion microne in pharmacy intravenous admixture services (PIVAS). METHODS:One thousaud and two hundred infusion information dispensed by PIVAS and 150 inpatients were collected from our hospital during Jan.-Dec. 2014(before implementation group)and Jan.-Dec. 2015(after implementation group). The number of suspended particles and sedimentated bacteria in different levels of clean area in PIVAS,the number of particles in dispensed infusion and the occurrence of ADR caused by infusion particles were compared before and after the implementation of details thinking management as strengthening working system,improving the quality of staff,implementing management during whole process,etc. RESULTS:After the implementation of details thinking management,the number of sus-pended particles and sedimentated bacteria in different levels of clean area were decreased significantly compared to before imple-mentation,with statistical significance(P<0.05). The number of particles ≥10 μm and ≥25 μm among electrolyte,TCM injec-tion and digestive system agents infusion,the number of particles ≥10 μm among antibiotics infusion and the number of parti-cles ≥25 μm among vitamin infusion were all decreased significantly compared to before implementation;the number of rubber and glass particles among dispensed infusion were decreased significantly with statistical significance (P<0.05). The incidence of ADR as blood vessel blockage,edema,phlebitis and heat source reaction were all decreased compared to before implementation, with statistical significance(P<0.05). CONCLUSIONS:The implementation of details thinking management can improve clean de-gree of different levels of clean area in PIVAS,and reduce the number of particles in various dispensed infusion so as to improve the quality of dispensed infusion to certain extent and guarantee the safety of drug use.