我国静脉用药集中调配中心可持续发展的关键要素分析 点击下载
论文标题: 我国静脉用药集中调配中心可持续发展的关键要素分析
英文标题:
中文摘要: 目的:探讨影响静脉用药集中调配中心(PIVAS)可持续发展的关键要素,为PIVAS的持续健康发展提供理论依据。方法:通过在PubMed、中国知网、万方数据库和维普网中检索1999年1月-2020年7月发表的与PIVAS发展相关的文献。采用回顾性研究方法,结合近20余年我国PIVAS的运行情况以及发展轨迹,并以我院PIVAS近10年的实际发展经验为基础,从药品管理、质量控制、药师专业素质提升、药学服务延伸、成本与效益5个方面分析影响PIVAS可持续发展的关键要素。结果与结论:药品库存、药品效期、药品“日盘点”、高警示药品、药品破损、药品滞销和药品短缺是PIVAS药品管理的关键要素;人员质量控制、环境质量控制、成品输液质量控制是PIVAS质量控制的关键要素;PIVAS药师专业能力、沟通和服务能力的提升是药师专业素质提升的􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂arethemostcommonthrombophilicgeneticnucleotidereceptorbyheparin-bindingEGF-likegrowthfactorbutpolymorphismsininfertilewomenundergoinganIVFcy-notbyEGF[J].ProcNatlAcadSciUSA,1994,91(25):cle?[J].GynecolEndocrinol,2016,32(11):896-899.12173-12177.[37]STOCKERL,CAGAMPANGF,CHEONGY.Identifying[41]MICHALSKYMP,KUHNA,MEHTAV,etal.Heparin-stablyexpressedhousekeepinggenesintheendometriumbindingEGF-likegrowthfactordecreasesapoptosisinin-offertilewomen,womenwithrecurrentimplantationfail-testinalepithelialcellsinvitro[J].JPediatrSurg,2001,36ureandrecurrentmiscarriages[J].SciRep,2017.DOI:10.(8):1130-1135.1038/s41598-017-07901-6.[42]ARMANTDR,KILBURNBA,PETKOVAA,etal.Hu-[38]CHOBOTOVAK,SPYROPOULOUI,CARVERJ,etal.mantrophoblastsurvivalatlowoxygenconcentrationsre-Heparin-bindingepidermalgrowthfactoranditsreceptorquiresmetalloproteinase-mediatedsheddingofheparin-ErbB4mediateimplantationofthehumanblastocyst[J].bindingEGF-likegrowthfactor[J].Development,2006,MechDev,2002,119(2):137-144.133(4):751-759.[39]CHOBOTOVAK,KARPOVICHN,CARVERJ,etal.Heparin-bindingepidermalgrowthfactoranditsreceptors[43]CONSTANCIAM,HEMBERGERM,HUGHESJ,etal.mediatedecidualizationandpotentiatesurvivalofhumanPlacental-specificIGF-Ⅱisamajormodulatorofplacen-endometrialstromalcells[J].JClinEndocrinolMetab,talandfetalgrowth[J].Nature,2002,417(6892):945-2005,90(2):913-919.948.[40]AVIEZERD,YAYONA.Heparin-dependentbindingand[44]MOLLERAV,JØRGENSENSP,CHENJW,etal.Gly-autophosphorylationofepidermalgrowthfactor(EGF)cosaminoglycansincreaselevelsoffreeandbioactiveIGF-Δ基金项目:河北省医学科学研究课题(No.20190201)Ⅰinvitro[J].EurJEndocrinol,2006,155(2):297-305.*主任药师。研究方向:医院药学、PIVAS管理与合理用药。电(收稿日期:2020-08-26修回日期:2020-09-23)话:0311-85988076。E-mail:13503291608@163.com(编辑:刘明伟)中国药房2020年第31卷第23期ChinaPharmacy2020Vol.31No.23·2901·关键要素;基于PIVAS处方审核系统的全用药医嘱审核和精准冲管数据库的建立及应用、专业药物咨询与临床宣教、细胞毒药物的全程药学监护、PIVAS药品不良反应监护是药学服务延伸的关键要素。虽然PIVAS建设以及运行的成本(土木工程、基础设施、人员)高于传统的药学服务模式,但其不仅带来了一定的经济效益和社会效益,而且在促进临床合理用药、减少药品不良反应等方面具有深远而积极的影响。总之,药师专业能力、沟通能力的提升,严格的药品管理以及质量控制,不断延伸药学服务、提高专业影响力、扩大社会影响力,合理的收费机制,可促进PIVAS持续健康发展。
英文摘要: OBJECTIVE:To explore the key factors affecting the sustainable development of pharmacy intravenous admixture service(PIVAS),and to provide theoretical basis for the healthy development of PIVAS. METHODS :Retrieved from PubMed , CNKI,Wanfang database and VIP ,literatures related to the development of PIVAS. Combining with the actual operation and development of PIVAS in China in recent 20 years,based on actual experience of PIVAS in our hospital in recent 10 years,the key factors affecting the sustainable development of PIVAS were analyzed by retrospective method from five aspects ,i.e. drug management,quality control ,pharmacists’professional quality improvement ,pharmaceutical care extension ,cost and benefit. RESULTS & CONCLUSIONS :The key elements of PIVAS drug management included drug inventory ,expiration date ,daily inventory,high-warning drug ,drug damage ,slack demand of drug and drug shortage. The key elements of PIVAS quality control included personnel quality control ,environment quality control and quality control of finished infusion. Improving the professional ability and communication service ability of pharmacists were the key factors to improve the professional quality of pharmacists. The establishment and application of medication order review and accurate flushing database based on PIVAS prescription audit system,professional drug consultation and clinical education ,whole pharmaceutical care of cytotoxic drugs and PIVAS adverse drug reaction monitoring were the key elements of pharmaceutical service extension. It can promote the sustainable and healthy development of PIVAS to improve pharmacists ’professional ability and communication ability ,strictly drug management and quality control ,continously extend pharmaceutical care ,improve professional influence and expand social influence and formulate reasonable charging mechanism.
期刊: 2020年第31卷第23期
作者: 庞国勋,王涛,靳会欣
英文作者: PANG Guoxun ,WANG Tao,JIN Huixin
关键字: 静脉用药集中调配中心;可持续发展;影响因素;合理用药
KEYWORDS: PIVAS;Sustainable development ;Influential factor ;Rational drug use
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