Videau Manon, Atkinson Suzanne, Thibault Maxime, Lebel Denis, Bussières Jean-François
is a Research Assistant in the Research Unit in Pharmaceutical Practice, Centre hospitalier universitaire Sainte-Justine, Montréal, Quebec.
, BPharm, MSc, is Assistant Director of the Pharmacy Department and the Research Unit in Pharmaceutical Practice, Centre hospitalier universitaire Sainte-Justine, Montréal, Quebec.
Can J Hosp Pharm. 2019 May-Jun;72(3):175-184. Epub 2018 Jun 30.
Pharmacists are required to maintain a secure inventory of medications and to ensure proper, safe, and diversion-free dispensing practices.
The primary objectives of this study were to determine compliance with recommended practices for the management of controlled substances in a mother-child teaching hospital and to identify actions to improve compliance. The secondary objective was to identify steps in the drug pathway for controlled substances and associated failure modes in the study hospital.
This descriptive cross-sectional study used a framework developed by the California Hospital Association (CHA) to assess compliance with recommended practices for the management of controlled substances in hospitals. For each criterion, a research assistant observed practices within the pharmacy, on patient care units, at outpatient care clinics, and in operating and delivery rooms. The level of compliance was recorded as compliant, partially compliant, or noncompliant. An Ishikawa diagram was developed to illustrate steps in the drug pathway and associated failure modes related to the use of controlled substances in the study hospital.
The pathway for controlled substances at the study hospital was compliant for 56 (49.6%) of the 113 CHA criteria, partially compliant for 27 (23.9%) of the criteria, and noncompliant for 24 (21.2%) of the criteria; the remaining 6 (5.3%) criteria were not applicable. This practice evaluation highlighted 22 corrective actions, 12 (55%) that could be implemented in the short term, 8 (36%) suitable for implementation in the medium term, and 2 (9%) suitable for both the short and medium term. A total of 57 potential failure modes related to the use of controlled substances were identified.
The pathway for controlled substances at the study hospital was compliant with almost half of the CHA criteria, and 22 corrective actions were identified. Pharmacists, physicians, and nurses should be mobilized to optimize the use of controlled substances throughout the drug-use process.
药剂师需要维持药品库存安全，并确保药品调配操作得当、安全且无药品滥用情况。
本研究的主要目的是确定一家母婴教学医院在管制药品管理方面对推荐做法的遵守情况，并确定改进合规性的措施。次要目的是确定研究医院中管制药品的用药途径步骤及相关失效模式。
这项描述性横断面研究使用了加利福尼亚医院协会（CHA）开发的框架来评估医院在管制药品管理方面对推荐做法的遵守情况。对于每个标准，一名研究助理在药房、患者护理单元、门诊诊所、手术室和产房观察实际操作情况。合规水平记录为合规、部分合规或不合规。绘制了一张石川图来说明研究医院中与管制药品使用相关的用药途径步骤及相关失效模式。
研究医院中管制药品的用药途径在CHA的113项标准中，56项（49.6%）符合要求，27项（23.9%）部分符合要求，24项（21.2%）不符合要求；其余6项（5.3%）标准不适用。此次实践评估突出了22项纠正措施，其中12项（55%）可在短期内实施，8项（36%）适合在中期实施，2项（9%）适合在短期和中期实施。共识别出57种与管制药品使用相关的潜在失效模式。
研究医院中管制药品的用药途径符合CHA近一半的标准，并确定了22项纠正措施。应动员药剂师、医生和护士在整个用药过程中优化管制药品的使用。
