Research On The Application Of Continuous Quality Improvement In Pharmacy Intravenous Admixture Service Management Of A Tertiary Teaching Hospital

Research background:The Pharmacy Intravenous Admixture Service(PIVAS)has many work links,high work intensity and complexity in the quality control process,as well as lack of uniform standards.Continuous Quality Improvement(CQI)is developed on the basis of total quality management.It follows the principle of PDCA cycle.Its meaning is to divide quality management into four stages,plan,do,check and action.Solves problems at different levels to promote each other and performs spiral rising cycle evaluation of processes,in order to improve efficiency and quality.The PIVAS of this study is a PIVAS from a newly built hospital,which faces more problems during the work.Therefore,the application of continuous quality improvement methods to analyze and improve the quality management system,processes and various work links is of great significance for improving the quality and efficiency of intravenous drug delivery.Research objective:According to the principle and method of CQI,the main problems of PIVAS in sample hospital are analyzed,and the implementation steps and strategies of quality improvement are put forward.We will continuously improve the quality management of PIVAS in workflow,personnel operation,environment,articles,and drug management.Evaluate the effectiveness of the application,put forward relevant countermeasures,and improve the quality improvement control system suitable for the development of PIVAS in sample hospital.To standardize the operation of PIVAS,reduce the incidence of errors,improve the quality,safety and timeliness of drug distribution,thereby improving the satisfaction of clinical services and patients.Research methods:Monthly inspection of the implementation of the five main work links of the prescription checking,arranging drugs,label checking,admixture preparation,packaging and transportation.,and the improvement of the four main management contents of drugs,articles,environment,and forms and documents.The configuration efficiency is analyzed by the statistics of long-term and temporary batch of drugs.Count the internal errors that occur every day in the internal parts of the department and the number of external errors that are feedback to the clinical department.Using the self-made PIVAS Clinical Service Satisfaction Questionnaire,monthly survey of clinical Department’s satisfaction with PIVAS.Compare the changes before and after the implementation of corrective measures and evaluate the effectiveness of the implementation of CQI.Main results:1)Standard rate of main links operation:prescription checking,arranging drugs,label checking,admixture preparation,packaging and transportation was increased from 88.99%,86.76%,88.21%,89.58%,87,29%to 95.52%,94.94%,94.47%,94.32%and 92.50%.2)The scores of the key management content:the management quality of environment,goods,drugs and table records was improved from 89.63points,83.13points,83.75points and 85.88pointsto 95.13points,95.13points,94.3 8points and 93.75points.3)Preparation efficiency:the preparation speed of long-term medical advice increased from 0.95 bags/min to 1.09 bags/min.The preparation speed of temporary medical advice increased from 0.63bags/min to 0.71 bags/min,and the preparation efficiency of long-term medical advice and temporary medical advice was significantly improved.4)Error quantity statistics results:all kinds of errors in PIVAS before and after the improvement were statistically analyzed,and the error rate decreased from 0.33 2‰ to 0.17‰.It can be seen that the incidence of PIVAS errors is significantly reduced after continuous quality improvement.5)Satisfaction with clinical services:the satisfaction degree increased from 91.77%to 95.98%,and the satisfaction degree of clinical medical workers on the work condition of PIVAS significantly increased after the implementation of continuous quality improvement.Conclusions and suggestions:Through the implementation of continuous quality improvement,the PIVAS workflow of sample hospital is more optimized,and the standardized operation of each link is improved,especially the efficiency of configuration is significantly improved.Pharmacy and nursing staff gradually formed a good working habit,the environment,goods,drugs management quality has been significantly improved.The incidence of errors was significantly reduced,and PIVAS clinical service satisfaction was also improved.Countermeasures and suggestions:The implementation of CQI begins with the improvement of rules and regulations,while paying attention to the training of personnel,and should fully recognize the necessity and feasibility of optimizing the process,and continuously improve the process to achieve the best results.Medical institutions should establish suitable management mode according to the actual situation,effectively implement PDCA cycle,and ensure the scientific nature of the evaluation and quantification proce’ss;enlist the support of management,drive the participation of all personnel;forming long-term mechanisms for continuous quality improvement;in addition,it is recommended that continuous quality improvement be combined with other management methods such as lean management and risk management to achieve better quality improvement results.