基于信息系统提示对静脉药物配置中心用药干预研究

摘要

目的：旨在探索信息系统给予静脉药物配置中心（ PIVAS）输液标签提示用药“特殊注意事项”的作用。方法：通过对住院患者长期输液医嘱的开具、药品的配置以及患者用药过程中给予输液标签提示用药“特殊注意事项”，以2012年和2013年PIVAS所配输液无“特殊注意事项”作为对照组，有“特殊注意事项”作为观察组，分别统计出静脉配置数出错率，重点追踪了我院一化疗药物使用后出现不良反应发生率及程度。结果：通过信息系统在输液标签中给予“特殊注意事项”提示，相关参数如溶媒的选择、溶媒量的选择、给药途径、输液速度（滴速）、给药顺序、给药频次和冲配好的药液放置时限等，其错误数和错误率观察组较对照组均显著下降（ P＜0．05）。通过HIS系统，重点监测化疗药物吉西他滨，查2012年和2013年使用了该化疗药物的病例，记录不良反应发生率及发生程度，结果发现较对照组，观察组不良反应发生率降低（P＜0．05），不良反应发生程度也降低（P＜0．05），并具有显著性差异。结论：信息系统在PIVAS中通过输液标签提示用药“特殊注意事项”，进一步规范了输液药物的调配、冲配和使用过程，提高了药师正确审方率、调配率，在使用过程中，护士也可方便地在输液标签中获取用药参数信息，使监管用药便利有效，以更好地安全、有效用药。%Objective:To explore information systems intravenous drug distribution center ( PIVAS) prompt medication infusion label "special considerations"role.Methods: Long-term infusion of inpatient medical advice issued, configuration and administration of drugs was given to patients during drug infusion labeling tips"Special Considerations"in 2012-2013 by the infusion PIVAS no"spe-cial considerations"with the control group , the"special considerations"as the intervention group were statistics intravenous configura-tion data error rate, focusing on tracking the incidence and severity of adverse reactions in our hospital after a chemotherapy drug use. Results:The information was given by the label in the infusion system "Special Precautions"prompt, in the intervention group, the relevant parameters such as the choice of solvent, amount of solvent choice, route of administration, the infusion rate ( drip rate) , the order of administration, administration frequency and impulse with good liquid placed time limits, the error number and the error rate less than in the control group ,These were significantly decreased (P<0.05).By HIS system, chemotherapy drugs gemcitabine was focused on monitoring, Searching the case of the chemotherapy drugs, recording incidence of adverse reactions and degree of occurrence and found that compared with the control group, the intervention group, incidence of adverse reactions and events were reduced ( P<0.05 )in 2012-2013 .Conclusions:Information systems in PIVAS prompted by an infusion of medication label "special considera-tions"to further standardize the process of Drug allocation, Flushing and using and to improve Rate of prescriptions and deployment, during the study, the nurses can easily acquire available parameter information in the infusion of medication label for convenient and ef-fective supervision of medication and medication safety.