本文選題：肝素鈉注射液 + 兒童患者��； 參考：《中國藥房》2017年34期

【摘要】：目的:促進(jìn)肝素鈉注射液在兒童用藥中的安全使用。方法:應(yīng)用醫(yī)療失效模式與效果分析法(HFMEA),通過文獻(xiàn)檢索、問卷調(diào)查、實地考察等方法,篩選肝素鈉注射液在兒童用藥過程中的失效模式,并針對這些失效模式制訂防范策略并實施,再通過比較實施前、后差錯率和風(fēng)險優(yōu)先級數(shù)(RPN)值評分評價實施效果。結(jié)果:通過RPN值評分共獲得5項需立即干預(yù)的肝素鈉注射液用藥風(fēng)險點,包括處方開具時肝素鈉注射液給藥劑量錯誤、藥品調(diào)劑時藥師不清楚肝素鈉注射液用量的計算方法、護(hù)理給藥時未執(zhí)行輸注前雙人核對流程等。經(jīng)制訂并實施相應(yīng)的防范策略后,肝素鈉注射液相關(guān)差錯由實施前的8例減少到1例,差錯率由3.76%降低到0.51%(P0.01);5項失效模式的RPN值分別由112.08、91.56、115.78、94.52、99.23下降到28.02、23.91、27.71、23.63、20.55。結(jié)論:應(yīng)用HFMEA可前瞻性地對肝素鈉注射液兒童用藥環(huán)節(jié)進(jìn)行系統(tǒng)的分析,再結(jié)合本院的實際情況制訂并實施對應(yīng)的防范策略后,可減少肝素鈉注射液使用中的相關(guān)差錯,促進(jìn)兒童用藥安全。
[Abstract]:Objective: to promote the safe use of heparin sodium injection in children. Methods: the medical failure mode and effect analysis (HFMEA) was used to screen the failure mode of heparin sodium injection in the course of drug use in children by means of literature retrieval, questionnaire investigation and field investigation. According to these failure modes, the preventive strategies are worked out and implemented, and the implementation effect is evaluated by comparing the error rate and the RPN score before the implementation. Results: five risk points of heparin sodium injection for immediate intervention were obtained by RPN score, including the wrong dosage of heparin sodium injection when prescription was prescribed, and the calculation method of heparin sodium injection dosage was not clear to pharmacists when the drug was adjusted. The double check procedure before infusion was not carried out in nursing administration. The relative errors of heparin injection were reduced from 8 cases to 1 case, and the error rate was reduced from 3.76% to 0.51% (P0.01). The RPN value of 5 failure modes was reduced from 112.08 to 28.0223.91.91,27.71and 23.630.55, respectively. Conclusion: HFMEA can be used to analyze the medication link of heparin sodium injection in children, and to make and implement the corresponding preventive strategy combined with the actual situation of our hospital, can reduce the related errors in the use of heparin sodium injection. To promote the safety of drug use in children.
【作者單位】： 山西省兒童醫(yī)院藥劑科;
【基金】：2016年國家衛(wèi)生和計劃生育委員會藥政司委托研究課題(No.藥政[2016]61號)
【分類號】：R952

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