摘要
目的探讨新生儿静脉全胃肠外营养液(TPN)集中配制的风险因素与安全管理。方法选取2019年12月至2020年12月本院经静脉用药调配中心(PIVAS)系统提取的住院新生儿TPN处方232份作为管理前组,选取2021年1—4月经PIVAS系统提取的住院新生儿TPN处方232份作为管理后组,管理前组实施常规管理方式,管理后组实施PDCA循环管理方式。比较两组新生儿TPN处方不合格发生情况、TPN处方不良事件发生情况及PIVAS配制的准确性和微粒污染发生情况。结果管理后组TPN处方不合格发生率为1.72%,低于管理前组的6.47%,差异有统计学意义(P<0.05)。管理后组TPN处方的加药环节、灌注环节及其他环节不良事件发生率均低于管理前组,差异有统计学意义(P<0.05)。管理后组TPN处方PIVAS配制的准确性高于管理前组,而微粒污染发生率低于管理前组,差异有统计学意义(P<0.05)。结论PDCA应用于TPN的PIVAS集中配制中管理效果显著,能提高PIVAS配制的准确性,为新生儿TPN临床应用的安全性和有效性提供保障。
Objective To investigate the risk factors and safety management of centralized preparation of intravenous total parenteral nutrition(TPN)for neonates.Methods 232 TPN prescriptions for hospitalized neonates extracted by the PIVAS system in our hospital from December 2019 to December 2020 were selected as the pre-management group,and 232 TPN prescriptions for hospitalized neonates extracted by the pharmacy intravenous admixture services(PIVAS)system in our hospital from January to April 2021 were selected as the post-management group,the pre-management group implements the conventional management method,and the post-management group implements the PDCA cycle management.The incidence of unqualified TPN prescription,the incidence of adverse events of TPN prescription,the accuracy of PIVAS preparation and the incidence of particulate pollution were compared between the two groups.Results The incidence of unqualified TPN prescriptions in the post-management group was 1.72%,which was lower than 6.47%in the pre-management group,and the difference was statistically significant(P<0.05).The incidence of adverse events in the dosing,perfusion and other links of TPN prescription in the post-management group were lower than those in the premanagement group,and the difference was statistically significant(P<0.05).The accuracy of PIVAS preparation of TPN prescription in the postmanagement group was higher than that in the pre-management group,while the incidence of particulate pollution was lower than that in the pre-management group,and the difference was statistically significant(P<0.05).Conclusion PDCA is applied in the centralized preparation of PIVAS of TPN,and the management effect is remarkable,which can improve the accuracy of PIVAS preparation,and provide guarantee for the safety and effectiveness of clinical application of neonatal TPN.
作者
钟明艳
黎峰
黄冠
邹博群
聂亚敏
ZHONG Mingyan;LI Feng;HUANG Guan;ZOU Boqun;NIE Yamin(Department of Pharmacy,Jiujiang Maternal and Child Health Hospital,Jiujiang,Jiangxi,332000,China)
出处
《当代医学》
2022年第25期93-95,共3页
Contemporary Medicine
基金
江西省卫生健康委科技计划(202140363)。
关键词
新生儿
PDCA循环管理
全胃肠外营养液
集中配制
安全管理
Neonate
PDCA cycle management
Total parenteral nutrition
Centralized preparation
Security management
