设计和实施一个Lomustine电路作为安全实践
Natalia Barreras Ruiz1, Paula Ortega Menendez1, Laura Jiménez Navarro1
1Fundación Jiménez Díaz University Hospital, Madrid, Spain.
概括
对高风险细胞毒性药物洛穆斯丁实施结构化药物循环,有效消除了患者药物错误. 这个系统提高了药物使用过程中的安全性和可靠性.
科学领域:
- 医疗保健安全 医疗保健安全
- 药物管理 药物管理
- 瘤学 药房 药房
背景情况:
- 在医疗保健中,患者安全至关重要,在充满挑战的家庭环境中,许多错误都会发生.
- 高风险药物,如洛穆斯丁,需要严格的安全协议,因为它们可能造成严重伤害.
- 理性的错误模型强调系统设计以减轻人类错误.
研究的目的:
- 为了调查药物错误,涉及过量服用洛穆斯.
- 设计和实施一个全面的药物循环,以防止未来的错误.
- 提高高风险化疗药物管理中的患者安全.
主要方法:
- 在药物错误事件发生后,进行了根本原因分析 (RCA).
- 采用了涉及瘤学和药学部门的多学科合作方法.
- 开发了一个结构化的药物循环,包括处方,验证,托管和发行阶段.
主要成果:
- 该RCA确定了导致Lomustine过量错误的关键过程点.
- 实施的Lomustine电路成功地解决了药物使用过程中发现的漏洞.
- 自该电路实施以来,没有报告了与洛穆斯丁相关的进一步的药物错误.
结论:
- 结构化药物循环是一种有效的策略,用于消除药物错误与高风险药物,如Lomustine.
- 开发的电路显著提高了洛穆斯的安全性和可靠性.
- 这种方法证明了系统级干预措施在提高瘤护理患者安全方面的成功.
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