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引用本文:李钧慧,陈梁芳,周奕辰,吕宁,滕天立,李伟俊,姜赛平.医疗失效模式与效应分析结合根本原因分析在医院麻醉药品智能化管理中的应用[J].中国现代应用药学,2023,40(17):2354-2359.
LI Junhui,CHEN Liangfang,ZHOU Yichen,LYU Ning,TENG Tianli,LI Weijun,JIANG Saiping.Application of Health Care Failure Mode and Effect Analysis Combined with Root Cause Analysis in Intelligent Management of Narcotic Use in the Hospital[J].Chin J Mod Appl Pharm(中国现代应用药学),2023,40(17):2354-2359.
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医疗失效模式与效应分析结合根本原因分析在医院麻醉药品智能化管理中的应用
李钧慧, 陈梁芳, 周奕辰, 吕宁, 滕天立, 李伟俊, 姜赛平
浙江大学医学院附属第一医院临床药学部, 杭州 310003
摘要:
目的 探讨联合应用医疗失效模式与效应分析(health care failure mode and effect analysis,HFMEA)和根本原因分析(root cause analysis,RCA)在医院麻醉药品智能化管理中的应用效果。方法 成立分析小组,运用HFMEA在医院麻醉药品智能化管理流程图中列出潜在失效模式,并结合RCA分析评估其中的关键失效模式,确定根本原因,进而制定改进措施并评估实施后的效果。结果 改进措施实施后,8项潜在失效模式的风险指数优先值均明显下降(P<0.05);药师、医师、护士对医院麻醉药品智能化管理流程的满意度分别由(88.39±2.21)%上升至(98.04±0.51)%,(87.79±1.36)%上升至(97.55±1.24)%,(90.79±1.39)%上升至(95.68±1.30)%。结论 HFMEA结合RCA可以降低麻醉药品流弊风险、保障药品质量安全、减少调剂错误发生、确保麻醉药品临床合理使用。
关键词:  医院麻醉药品  医疗失效模式与影响分析  根本原因分析  智能化管理
DOI:10.13748/j.cnki.issn1007-7693.20223171
分类号:R954
基金项目:
Application of Health Care Failure Mode and Effect Analysis Combined with Root Cause Analysis in Intelligent Management of Narcotic Use in the Hospital
LI Junhui, CHEN Liangfang, ZHOU Yichen, LYU Ning, TENG Tianli, LI Weijun, JIANG Saiping
Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
Abstract:
OBJECTIVE To discuss the application effect of health care failure mode and effect analysis(HFMEA) and root cause analysis(RCA) in the intelligent management of narcotic use in the hospital. METHODS Set up an analysis team to use HFMEA to list potential failure modes in the flow chart of intelligent management of narcotic use in the hospital, and analyze and evaluate the key failure modes in combination with RCA, determine the root cause, and then formulate improvement measures and evaluate the effects after implementation. RESULTS After the implementation of the improvement measures, the risk priority number of the eight potential failure modes decreased significantly(P<0.05). The satisfaction of pharmacists, doctors and nurses with the intelligent management process of narcotic use in the hospital increased from (88.39±2.21)% to (98.04±0.51)%, from (87.79±1.36)% to (97.55±1.24)%, and from (90.79±1.39)% to (95.68±1.30)%, respectively. CONCLUSION HFMEA combined with RCA can reduce the risk of narcotic drug abuse, ensure drug quality and safety, reduce the occurrence of dispensing errors, and ensure the rational clinical use of narcotic drugs.
Key words:  narcotic use in the hospital  health care failure mode and effect analysis  root cause analysis  intelligent management
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