手术用药闭环化管理模式的建立与持续改进

Establishment and Continuous Improvement of a Closed-loop Mode for the Management of Medications used During Surgery

关键词:  手术药房  药品管理  持续改进  药师  闭环化管理  麻醉医师

Key words:  operation pharmacy  drug management  continuous improvement  pharmacists  closed-loop mode  anesthesiologists

摘要:

目的 加强手术用药的质量与使用管理，保证患者术中用药安全、有效、及时。方法 在手术室成立手术药房，制订工作制度、岗位职责及标准操作规程，由药师负责对药品进行管理；以药箱和药盒为转运载体，对术中用药实行闭环化管理，即药师按照目录预先补充药箱和药盒中药品，麻醉医师手术前到药房领取所需药箱和药盒或其他药品，手术结束后将剩余药品和空安瓿交还手术药房，药师对药品实际使用量、医嘱开具量及空安瓿数量进行核对。结果 手术药房建立后，药品质量得到了有效监控，处方质量得到了显著提升，药品实际使用量、医嘱开具量及空安瓿数量达到了一致。结论 在手术室成立手术药房并建立闭环化药品管理模式，可实现对手术用药的精细化管理。

Abstract:

OBJECTIVE To ensure the safety,effectiveness and timeliness of medication during surgery through strengthened supervision of the quality and use of drugs.METHODS An operation pharmacy was established where pharmacists take responsibility for the quality of drugs,and the working systems,post responsibilities and standard operating procedures for its running were formulated;A closed-loop mode was constructed in the entire course of request,use and return of drugs by using cases and boxes as transporter.In this loop:Pharmacists filled the cases and boxes with drugs in advance according their respective catalogues;Anesthesiologists got the cases and boxes and other drugs if necessary from the operation pharmacy;After surgery,the anesthesiologists returned the remaining drugs and empty ampoules,which were checked by pharmacists in terms of the number of drugs actually used,prescribed in medical orders and the number of empty ampoules.RESULTS After the establishment of the operation pharmacy,drug quality has been monitored effectively,the quality of the prescriptions has been improved significantly,and an accordance among the number of drugs actually used,prescribed in medical orders and the number of empty ampoule has been achieved.CONCLUSION To establish an operation pharmacy with a closed-loop mode can realize the fine management of medications used during surgery.