Investigation And Intervention Study On Clinical Intravenous Practice In Chinese Hospitals

Objective: Comparing national differences in intravenous practice between the United States and China,and exploring the potential contextual factors and deficiencies in intravenous management and practice in China,to assess and predict the effectiveness of context-specific interventions on reducing the intravenous practice error rate in the intervention hospital,to compare the recognition of the situation of intravenous practice by professionals before and after the intervention,and to assess the actual impact of the intervention on professionals’ clinical intravenous work.Methods: We conducted a structured interview study in the US and China,and investigated the attitudes of Pharmacy Intravenous Admixture Services(PIVAS)directors.Further exploration of the infusions usage in inpatients and the PIVAS center was established.Then a single-center targeted intervention in three wards and PIVAS center was performed.And error rates were analyzed.Finally,comparative questionnaires were sent to staff to discover the improvement in their cognition and practices.Result : The questionnaire scores in the US have significant differences compared to China in five dimensions(P<0.05).Additionally,there were significant differences in the number or categories of inpatients’ daily infusions per capita and infusions per batch prepared in the PIVAS center between the US and China(P<0.001).Time series analysis demonstrated reductions in the total error rates.Significant differences were shown in the staff items answers in three wards pre-and postintervention(P<0.05),as for PIVAS center staff,significant differences were shown in the all items answers pre-and post-intervention(P <0.05)except for the education demension.Conclusion: The results showed heavier workloads and more inappropriate schedules in China than in the US.Additionally,staff is hard to obtain reliable information for BUDs.The risk for the efficacy and safety of infusions is relatively high.In addition,we found that targeted intervention significantly reduced the error rate in beyond-BUDs errors and incorrect storage conditions.Moreover,staff cognition and practices around BUDs and workload have improved significantly.Finally,this study may inspire the awareness of the importance of BUDs in intravenous practices.It could also provide references for targeted interventions around contextual factors in other countries for further research.