The Impact Analysis Of Continuous Improvement Of PIVAS Service Mode On Clinical Nursing Work

With the reform of the health care system, the duties and connotation of nursing workhas been changed and extended, which advocating the concept " human-oriented, patient-centered", requiring us to implement basic nursing care and patient safety goal, and finallyproviding high quality nursing service. How to make full use of and support nursingresources is the guarantee of implementing nursing services and also the core of modernnursing management.ObjectiveThis study aims to understand and analyze the current status of clinical nursing workserved by PIVAS in order to find out the problems in the present PIVAS service model.And then we demonstrate continuous improvement using PDCA cycle to take advantageof PIVAS in promoting clinical nursing work and perfecting the role of PIVAS insupporting and ensuring clinical nursing.Method1、On the basis of combining with literature review and clinical practice, we madequestionnaires according to advices of experts meeting and investigated nursing time intaking, returning, admixing and managing intravenous drug, management of intravenousdrugs stored in ward,and protection in admixing chemotherapy drugs in54clinicaldepartment. Then a satisfaction survey was also carried out among nurses in clinicaldepartment served by PIVAS to understand the influence of current service mode ofPIVAS in clinical nursing work.2、According to the problems found in present situation investigation, we set up a projectteam, used PDCA cycle theory to implement improvement by expanding service scope oflong-term intravenous drug,shortening delivery time of long-term intravenous drug, andcarrying out temporary intravenous drug distribution of24h, then evaluated the efficiencyof clinical work again.Result1、The PIVAS service for clinical nursing had a poor quality:(1) PIVAS onlydistributed4680bags of drugs accepted before12:00for42clinical departments.(2) Thenursing time in taking, returning, admixing, and managing intravenous drugs that nursestook in54clinical department were7790.21±360.60min、16620.24±1347.81min、2848.20±240.67min, which took up lots of nursing manpower resource.(3)Theintravenous drugs in clinical departement were numerals, diversified, and poorly-maintained.(4)72.45%of chemotherapy drugs were still prepared in clinicaldepartment. Although basic protection facilities and equipments were provided in theprocess of preparing chemotherapy drugs in54clinical departments, self protection levelof nurses was yet to improved.(5)The score of overall satisfaction to PIVAS was3.99+/-1.05points, and the service scope, working process and service effect had a lowsatisfaction score.2、After continuous improvement had been implemented, the quality of PIVAS servicefor clinical nursing work was improved significantly.(1)As for the long-term intravenousdrugs, the numbers of departments with long-term intravenous drug distribution increasedto54, the time that PIVAS accept orders of infusion extended to24h, the numbers of drugsthat PIVAS distributed increased to6085bags. PIVAS also implemented the24hdistribution for2019bags of temporary intravenous drugs everyday.(2)About27staffwere saved, and nurses had more manpower, time and energy contributing into clinicalcare.(3)The types and quantities of intravenous drugs were significantly reduced, and themanagement is more standardized. On-time delivery rate of long-term intravenous drugsincreased from91.00%to98.00%.(4) The drug safety was improved significantly. Therewere100bags of chemotherapy drugs admixed in PIVAS every day, which strengthenedthe occupational protection for nurses.（5）PIVAS has gained recognition by nurses, thescore of overall satisfaction to PIVAS increased from3.99+/-1.05points to4.70+/-0.53points, and especially the scope of services, service effect, workflow had statisticallysignificant differences.