| 刘叶芳,马玉琴,倪佳.依托六级电子病历建设医院高警示药品闭环管理[J].中国药事,2018,32(5):658-663 |
| 依托六级电子病历建设医院高警示药品闭环管理 |
| Closed Loop Management of High Risk Drugs Based on Level Six Electronic Medical Record |
| 投稿时间：2018-04-18 |
| DOI：10.16153/j.1002-7777.2018.05.015 |
| 中文关键词: 电子病历 高警示药品 闭环管理 医疗安全 医院药品管理 |
| 英文关键词: electronic medical record high risk drugs closed loop management medical safety hospital drug management |
| 基金项目: |
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| 中文摘要: |
| 目的：依托六级电子病历建设，提升我院高警示药品管理水平。方法：依据电子病历要求，将涉及高警示药品的每个重要医疗活动节点进行链式记录，纳入闭环管理。结果：通过医院六级电子病历信息化改造，将高警示药品纳入闭环管理，提高了医院对病人完整医疗信息的获取和处理能力，大大减少了用药差错，将高警示药品潜在的、可能导致严重后果的用药差错消灭在萌芽状态；缩短了各流程的时间，使病人及时、准确、安全用药；促进药师参与临床，提升临床药学服务水平。结论：我院高警示药品管理工作由原来的经验管理向科学管理发展，即从传统的末端、事后管理转向过程管理，最终实现从粗放式管理转向精细化管理，真正做到医疗质量的事前管理和实时监控，有效地规范了医护人员的行为，有利于提高医疗效率、保障医疗安全。 |
| 英文摘要: |
| Objective:To improve management of high risk drugs in our hospital based on the construction of level six electronic medical records. Methods:According to the requirements of electronic medical records, chain records for every important medical activity node involving high risk drugs and incorporated into closed loop management were carried out. Results:High risk drugs were incorporated into closed loop management through the level six electronic medical records informatization transformation. The ability to obtain and handle complete medical information of patients in our hospital was improved. The potential and serious medication errors caused by high risk drugs were greatly reduced at an early stage. The process time was also greatly shortened to ensure patients timely, accurate and safe drug use. The level of clinical pharmaceutical services was improved by promoting the participation of pharmacists in clinic. Conclusion:The management of high risk drugs in our hospital has been improved, from the original experience management to the scientifc management, that is from the traditional terminal or afterwards management to process management, and fnally from extensive management to fine management so as to truly carry out pre-action management and real-time monitoring and effectively standardize the behavior of medical staff and improve the effciency of health care and ensure the medical safety. |
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