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医院冷库储藏药品管理现状与策略
发布时间:2020-01-31

  摘要:赢发彩票代理目的:探讨医院冷藏药品管理中的问题分析及管理对策,保证冷藏药品质量。方法:将医院各科室冷藏药品作为研究标本,分析医院各科室在2015年的冷藏药品管理中发生的不良事件,分析其因素并制定针对性有效对策,医院各科室在2016年全面实施有效性冷藏药品管理对策,观察其实施前后的管理效果。结果:实施前不良事件发生104起,实施后不良事件发生44起,有效控制与减少冷藏药物管理不良事件的发生情况。结论:通过完善冷藏药品管理制度,增强冷藏药品管理意识和水平。

  关键词:医院冷藏药品管理; 问题分析; 管理对策;

  LENGZANGYAOPINGUOCHENGZHONGHUISHOUHUANJINGYINSUYURENWEIYINSUDEYINGXIANG,LIRUWENDU、CHAOSHIDUJIYUNSONGSHIJIANZHANGDENGYINSU,DAOZHIYAOPINLIAOXIAOJIANGDIHUOYAOPINBIANZHI,HUANZHESHIYONGHOUKECHUXIANZHUDUOBULIANGFANYINGHUODUFUZUOYONG,CONGERYINFAYILIAOSHIGU,DUIHUANZHEJIYIYUANMINGYUZAOCHENGBULIYINGXIANG[1].LENGZANGYAOPINDEYOUXIAOGUANLISHIYIYUANYAOPINZHILIANGJIANKONGDEZHONGYAOZUCHENGBUFEN,GENJUYAOPINGUANLIYANJIUBAODAO,BAOCUNWENDUDIZENG2℃,QILENGZANGYAOPINDEBAOZHIQISUIZHISUODUAN20%[2,3].DUICI,YINGJIAQIANGYIYUANLENGZANGYAOPINGUANLI,ZHENDUIBULIANGSHIJIANFASHENGYINSUJINXINGDIAOCHA、FENXI,BINGGENJULINCHUANGJINGYANYULINCHUANGZILIAOZHIDINGYOUXIAOXINGDEGUANLIDUICE,CONGERNENGGOUCONGGENBENSHANGYUFANGHEJIANSHAOBULIANGSHIJIANDEFASHENG。BENWENDUIYIYUANLENGZANGYAOPINGUANLIZHONGDEWENTIFENXIJIGUANLIDUICEJINXINGTANTAO。

  1、资料与方法

  1.1 一般资料

  JIANGYIYUANGEKESHILENGZANGYAOPINZUOWEIYANJIUBIAOBEN,FENXIYIYUANGEKESHIZAI2015NIANDELENGZANGYAOPINGUANLIZHONGFASHENGDEBULIANGSHIJIAN,FENXIQIYINSUBINGZHIDINGZHENDUIXINGYOUXIAODUICE,YIYUANGEKESHIZAI2016NIANQUANMIANSHISHIYOUXIAOXINGLENGZANGYAOPINGUANLIDUICE,GUANCHAGUANLIDUICESHISHIQIANHOUDEGUANLIXIAOGUO。BENYANJIUDUIXIANGWEIGEBUMENDELENGZANGYAOPIN,YOUGUANLIXIAOZUDUIMEIGEKESHIDELENGZANGYAOPINGUANLIBULIANGSHIJIANJINXINGJILUYUDIAOCHA,GUANLIXIAOZUYOUYAOPINGUANLIZHUANYERENYUAN3MINGZUCHENG。

  1.2 方法

赢发彩票代理   1.2.1 LENGZANGYAOPINGUANLIDEWENTI

赢发彩票代理   (1)WEN、SHIDUGUANLIWEIDAOWEI。YIN《ZHONGGUOYAODIAN》SHENGWUZHIPINDEWENDUXUYANGEKONGZHIWEI2℃~8℃,SHENGWUZHIPINDECHUZANGWENDUSHILENGZANGYAOPINDEZHUTI,YINCIYAOPINDELENGZANGWENDUBIXUWEICHIZAI2℃~8℃DEFANWEINEI。LENGZANGWENDUDEBIANHUADEBUDAO24hDEQUANFANGWEIJIANDUYUKONGZHI,YINCIWENDUYIDANCHUXIANJIAODADEFUDONG,WEIJISHIFAXIANKEDAOZHIYAOPINDEZHILIANGCHUXIANBIANHUA。LENGZANGYAOPINGUANLIGONGZUORENYUANZAIDUIYAOPINKUFANGDEMEITIANWENDUYUSHIDUJINXINGJILU,RONGYIHUSHIBINGXIANGZHONGDEYAOPINWENSHIDUDEJIANCHA,TONGSHILENGZANGYAOPINDADUOSHUYUZHENJI,RUOCHAOSHIDUJIAOGAO,RONGYIYINGXIANGYAOPINBAOZHUANGDEXINXI,SHIDUBIANCHENGDALIANGSHUIFENJINSHIYAOPINBAOZHUANGHE,CONGERSHIDEBAOZHUANGHESHUOMINGSHUXINXIMOHUBUQING,SHENZHIWUFABIANSHIYAOPINDEFENLEIJIMINGCHENG,QIBUJINZENGJIAGUANLIDEGONGZUOLIANG,HAIKEYINGXIANGZHENGQUESHIYONGYAOPINDEPANDUAN,YIYOUFABULIANGYILIAOSHIGU。

  (2)SHESHIYINGJIANTOUFANGBUZU。LENGZANGYAOPINDEGUANLIZHIDUBUGOUWANSHAN,QIEYIYUANLINGDAOBUZHONGSHI,YINCIQUEFALENGZANGSHEBEI,ERQIEZAIYIYUANYAOPINKUFANGDESUOZHANNEICUNJIAOXIAO,LENGZANGYAOPINDECUNFANGJUNCAIYONGBINGXIANG,RONGYIZAOCHENGBUBIAN,LINGWAIMEIYOUJIANKONGBAOJINGXITONG,WUFABAOZHENGBINGXIANGWENDUDEBAKONGZHILIANG。ZAIYAOPINCUNQUGUOCHENGZHONGHAIYAOKONGZHIBINGXIANGDEDAKAISHIJIAN,RUOBINGXIANGDAKAISHIJIANJIAOZHANG,RONGYISHIBINGXIANGDEWENDUSHENGGAO,LINGWAIJIECHUWAIMIANREKONGQI,YERONGYISHIYAOPINFASHENGZHIBIAN,SUIZHELENGZANGYAOPINZHONGLEIDEZENGDUO,BINGXIANGDEKONGQILIUDONGXINGJIANGDI,CONGERDAOZHIBINGXIANGDEWENDUBIANHUADA,LINGWAICUNFANGKONGJIANXIAZHAIYERONGYIDAOZHIYAOPINDESUNHUAI。

  (3)LENGZANGCUNFANGFANGFABUDANG。GUANLIRENYUANWEISHENGCHUBINGXIANGKONGJIAN,QIEYONGLIJIANGYAOPINSAIMANZHENGGEBINGXIANG,QIBUJINDUIYAOPINQUYONGZAOCHENGBUBIAN,TONGSHIHAIHUIRONGYIDAOZHIBINGXIANGDEZHILENGXITONGCHUXIANYICHANG;GUANLIRENYUANDUILENGZANGYAOPINDEXINGZHIJICHUZANGYAOQIULEJIESHENSHAO,CONGERYINGXIANGYAOPINDESHIYONGZHILIANG,LIRUSHENGZHANGYIZHISUHUOGANSUNADENGYAOPIN,WANGWANGGUANLIRENYUANJIANGCILEIXUYAOLENGZANGDEYAOPINFANGZHICHANGWENCHU。TONGSHI,YINBINGXIANGCHUZANGKONGJIANYOUXIAN,DAOZHIGUANLIRENYUANJIANGBUTONGZHONGLEIDEYAOPINHUNFANG,LIRUYANSEYUBAOZHUANGXIANGSIDEYAOPINMENDONGYIDAOSU、NUOHELINGDENGHUNZACUNFANG,RONGYICHANSHENGHUNXIAO,QIEDUIHUANZHEYONGYAOCUNZAIJIAODADEANQUANYINHUAN。ZAICUNFANGHEQUYONGLENGZANGYAOPINSHI,WEIJIANLILENGZANGYAOPINDENGJIXITONG,QUEFAZHUANMENLENGZANGYAOPINDEXINXIJILU,CONGERDAOZHIYAOPINGGUANLIHUNLUAN,RONGYIHEDUICHUCUO,JIANGDIGUANLIZHILIANG。

赢发彩票代理   (4)LENGZANGXIANJIECUNZAILOUDONG。LENGZANGWUPINYUNSONGGUOCHENGZHONGYEKECUNZAIWEIXIEYAOPINZHILIANGDEFENGXIAN,CIWAIHULIRENYUANJINXINGYAOPINPEIZHIGUOCHENGZHONGJIZHONGBAIFANGRONGYISHIQIHUNXIAO,BAOLUSHIJIANZHANGRONGYIKEDAOZHIYAOPINXINGZHICHUXIANGAIBIAN,BUFENLENGZANGYAOPINDEWENDINGXINGYUWENDUYOUGUAN,YINCIGANRAOYAOXIAONONGDU,YANWUYAOXIAOFENGZHISHIJIAN,HUANZHEDEZHILIAOXIAOGUOBUXIANZHE。

赢发彩票代理   1.2.2 YOUXIAOXINGDUICE

赢发彩票代理   (1)ZENGJIALENGZANGYINGJIANSHESHI。ZHENDUIWOYUANLENGZANGYAOPINDEXIANZHUANGXIANGYIYUANLINGDAOSHENQINGLENGZANGCHUZANGSHI、DIANZIJISUANJIJILUXITONGJIYIDONGSHIDELENGZANGXIANGDENGSHEBEI,TONGGUOJIANSHEZHUANSHUDELENGZANGYAOPINCHUZANGKUFANG,BUDANNENGGOUZENGJIACHUZANGKONGJIAN,HAIKETIGAOGUANLIXIAOLV,BIANYUFENLEI、CUNFANGJIQUYONG;TONGGUOLIYONGDIANZIJISUANJIXITONGJINXINGGUANLI,NENGGOUZIDONGQUANTIANJIANKONGLENGZANGDEWENDUWENDINGQINGKUANG,TONGGUOCAIYONGXIANGYINGBAOJINGYUBEIGUANLI,ZHENDUITINGDIANQINGKUANGNENGGOUJINXINGJINJIYINGDUIFANGAN,SHELILENGLIANGUANLIWENDANGBEIAN,KEYOULIYUCHAZHAO。CAIYONGYIDONGSHILENGZANGXIANGKESUOJIANYUNSONGSHIJIAN,TONGSHIHAIKEBAOZHENGZAIYUNSONGGUOCHENGZHONGNENGYOUXIAOBAOZHENGYAOPINZHILIANGJIANQUANXING。YOUYUZIJINYOUXIAN,MUQIANZHIYOUYAOKUPEIBEILENGKU,MENJIZHEN、ZHUYUANYAOFANGPEIBEIYAOPINZHUANYONGBINGXIANG,KEZIXINGDIAOJIEWENDU,JISUANJILENGLIANLIANJIEXITONG,DANSHISHUYESHI、XUETOUSHIZHIPEIBEIPUTONGBINGXIANG,GEBINGQUWEIPEIBEIXIANGYINGSHESHI,ZHEIXUYAOYUANLINGDAOZHONGSHICAINENGSHIXIAN。

  (2)WANSHANLENGZANGYAOPINDEGUANLIZHIDU。YANGEZHIXINGLENGZANGYAOPINYANSHOUZHIDU。LENGZANGYAOPINDAODAYIYUANYAOKU,CANGKUBAOGUANYUANZAISHOUHUOSHI,ZHONGDIANJIANCHABINGHEDUIDAOHUOWENDUJIZAITUWENDU,HEGEHOUFANGKERUKU,FOUZEZHIJIETUIHUOCHULI。BINGJIANGZAITUWENDUFUYINBAOCUNZHUANGDINGCHENGCE。

赢发彩票代理   DUIYULENGZANGYAOPINCHUKUDEQINGKUANG,YAOKUFAFANGZHIMENJIZHEN、ZHUYUANYAOFANGCAIYONGYIDONGLENGZANGXIANG,GEBINGQULINGYONGKECAIQUBINGDAIBAOWEN,TONGSHIXIANGHULIRENYUANSHUOMINGYAOPINDEXINGZHIJILENGZANGDEZHUYISHIXIANG。

赢发彩票代理   (3)CAIYONG“WUCHANGFA”[4],JIAQIANGLENGZANGYAOPINGUANLI。“WUCHANGFA”QIYUANYURIBEN,SHIStructurise(CHANGZUZHI)、Systematise(CHANGZHENGDUN)、Sanitise(CHANGQINGJIE)、Standardise(CHANGGUIFAN)、Self-discipline(CHANGZILV)ZHEI5GEDANCIDESHOUZIMU,JIANCHENG5S.5SZAIYAOFANGJINGXIHUAGUANLI、KEXUEHUAGUANLIZHONGQIZHEZHONGYAOZUOYONG,YOUZHUYUTIGAOLENGZANGYAOPINZHILIANG。ZAIKENEICHANGZUZHIXUEXITAOLUNLENGLIANGUANLIDEFANGFAJIQIZHONGYAOXING;JIANGKANSIYAOPINHELIFENPEIBINGXIANG,BINGBIAOZHUYISHIQUFEN;MEITIANZHENGLILENGKUHUOBINGXIANG,JIANGBUYAODESULIAOBAOZHUANGQINGLIGANJING;MEIYUEBUDINGQIJIANCHA,FAXIANWENTIJISHITAOLUNJIEJUE,QUEBAOZHIDULUOSHI;YAOSHIMEITIANLIANGCI,JILULENGKUHUOBINGXIANGWENSHIDUHEDIANNAOXITONGDELENGLIANQINGKUANG;YANGEPAICHAJIEJINBAOZHIQIDEYAOPIN,BINGTONGGUOCAIYONGJIANCHAYUJILUDEZHIDU,DUILENGKUHUOYAOPINZHUANYONGBINGXIANGDEQINGKUANGJINXINGJILU,ZHENDUIYAOPINZHONGLEIJIAODUODEQINGKUANG,XUTONGYIYANGEZUNSHOUWENDUKONGZHIZAI2℃~8℃,SHIDUKONGZHIWEI45%~75%.CHULEJIANCHAYAOPINZHIWAI,HAIYAOJIAQIANGSHEBEIDEJIANCHA,BUDINGQIJIANCHAHEWEIXIULENGZANGSHEBEI,JILUQIGUZHANG、QUESUN、DUANDIANHUOQUEDIANQINGKUANG。HAIYAOZUNXUN“JINQIXIANCHU,XIANJINXIANCHU,ANZHAOPIHAOCHUKU”DECHUKUYUANZE,GEKESHIYAOFANGYAOPINBEIZHANGSHIJIANZHIXIAO,XUYAOJIZAOTUIHUIYAOKU,BINGZUOHAOBIAOZHU,ZHENDUIKAIQIDEYAOPINXUJIANGKAIQIRIQIYUSHIJIANBIAOZHUYUYAOPINBAOZHUANGSHANG。

  1.3 TONGJIXUEFANGFA

  SHUJUCHULICAIYONGSPSS 19.0RUANJIAN,%WEIJISHUZILIAO。YIP<0.05BIAOSHICHAYIJUYOUTONGJIXUEYIYI。

  2、结果

  SHISHIYOUXIAOXINGDUICEQIANYAOWUBIANZHI44QI,DIAOPEICUOWU28QI,BAIFANGBUDANG32QI,ZONGBULIANGSHIJIANFASHENG104QI;SHISHIYOUXIAOXINGDUICEHOUYAOWUBIANZHI20QI,DIAOPEICUOWU10QI,BAIFANGBUDANG14QI,ZONGBULIANGSHIJIANFASHENG44QI,GUANLIBULIANGSHIJIANMINGXIANJIANSHAO(P<0.05)。JIANBIAO1.

表1 实施前后不良事件发生情况比较(起)

实施前后不良事件发生情况比较

  3、讨论

  YIYUANLENGZANGYAOPINYIBANWEIZHENJI、SHENGWUZHIPINJIXUEYEYAOPINDENG,YOUYULENGZANGYAOPINDECHUZANGTIAOJIANYUHUANJINGYINSUYOUGUAN,LENGZANGYAOPINHUIYINWENDUYUSHIDUDEYINSUERYINGXIANGYAOXIAO,LINGWAIRENWEIYINSUYEKEDAOZHIYAOPINDESHIXIAO,BUDANWEIXIEHUANZHEDEANQUAN,HAIHUITIGAOYIYUANDEYILIAOCHENGBEN,YINGXIANGYIYUANDESHENGYU[5,6].

赢发彩票代理   TONGGUOFAXIANHEDIAOCHALENGZANGYAOPINGUANLIZHONGCHUXIANDEWENTI,FENXIQIYINSU,BINGZHENDUIWENDUKONGZHI、LENGZANGSHEBEIJIGUANLIZHIDUJINXINGGANYU,JIAQIANGGUANLIZHIDU,TIGAOYAOPINGUANLIDEANQUANYISHI,SHENQINGLENGZANGSHEBEI,BUDANYOULIYUCUJINGUANLI,HAIKETIGAOGUANLIRENYUANDEZHUANYEXINGYUZENGQIANGGUANLILIDU,QUANMIANGAISHANGUANLIZHIDU,BUDANNENGGOUJIEJUEYAOPINCHUKUYUCUNFANGWENTI,HAIKEYOULIYUYAOPINLENGZANGANQUANXINGDEDAOBAOZHANG,BIMIANGUANLIZHONGBULIANGSHIJIANDEFASHENG,BAOZHENGHUANZHEYONGYAOANQUAN[7,8].

  TONGGUODUILENGZANGYAOPINJINXINGZHENDUIXINGGUANLI,KEYOUXIAOBAOZHENGYAOPINDEZHILIANG,HAINENGGOUTIGAOGUANLIXIAOLV。BENYANJIUTONGGUOGUANCHAWOYUANLENGZANGYAOPINGUANLIZHONGDEWENTI,FAXIANQIZHONGYINGXINGSHEBEILENGZANGTIAOJIAN、WENSHIDUKONGZHIYINSU、LENGZANGGUANLIZHIDUQUESHIDENGJUNRONGYIYOUFALENGZANGYAOPINGUANLIBULIANGSHIJIAN,TONGGUODUIQIWENTIJINXINGFENXI,BINGJIYUZHENDUIXINGYOUXIAODUICEGUANLI,KEYOUXIAOJIANSHAOBULIANGSHIJIANDEFASHENGQINGKUANG[9,10].

赢发彩票代理   ZONGSHANGSUOSHU,DUIYIYUANLENGZANGYAOPINGUANLIWENTIJINXINGFENXI,BUDANNENGGOUZHAOCHUBULIANGSHIJIANFASHENGDEYINSU,HAIKEJIYUXIANGYINGDEDUICEJINXINGYUFANG,TIGAOLENGZANGYAOPINGUANLIXIAOLV,BAOZHENGYAOPINGUANLIDEZHILIANG。

  CANKAOWENXIAN

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