目的 探討失效模式與效應(yīng)分析（failure mode and effect analysis，F(xiàn)MEA）在住院藥房藥品調(diào)劑流程風(fēng)險管理中的應(yīng)用效果，提高藥品調(diào)劑質(zhì)量。方法 對天津醫(yī)科大學(xué)腫瘤醫(yī)院住院藥房口服藥物調(diào)劑流程中各個環(huán)節(jié)進行FMEA，計算風(fēng)險優(yōu)先指數(shù)（risk priority number，RPN）。選出高風(fēng)險等級的失效模式和中等風(fēng)險等級中S≥4的失效模式，整理分析其失效原因，制定并實施改進措施。比較實施FMEA方法前后失效模式變化情況，分析改進效果。結(jié)果 住院藥房藥品調(diào)劑流程中共找出13個失效模式，其中高風(fēng)險失效模式4項，極高風(fēng)險失效模式2項。通過規(guī)范藥物醫(yī)囑流程、優(yōu)化HIS信息系統(tǒng)與擺片機對接執(zhí)行程序、修訂完善制度以及對藥師、護士進行培訓(xùn)等方面干預(yù)，13項失效模式RPN均值由38降至15，降幅為60.53%。其中4項高等風(fēng)險失效模式經(jīng)改進后風(fēng)險明顯降低，且差異有統(tǒng)計學(xué)意義（P＜0.05）。結(jié)論 將FMEA應(yīng)用于住院藥房藥品調(diào)劑流程風(fēng)險管理，能夠有效降低拆藥過程藥品損失、機器誤差、HIS系統(tǒng)與擺片機信息對接失誤和取藥次數(shù)多、等候時間長等問題，提高藥品調(diào)配的及時性和準確性，更好地服務(wù)于住院患者。

Objective To explore the application effect of failure mode and effect analysis (FMEA) in the risk management of drug dispensing process in inpatient pharmacy, and improve the quality of drug dispensing. Methods FMEA was performed on each link of oral drug dispensing process in inpatient pharmacy of Tianjin Medical University Cancer Hospital, and risk priority number (RPN) was calculated. The failure mode of high risk level and the failure mode of S ≥ 4 in medium risk level are selected, the failure causes are analyzed, and the improvement measures are formulated and implemented. The change of failure mode before and after the implementation of FMEA method was compared, and the improvement effect was analyzed. Results A total of 13 failure modes were found in the drug dispensing process of inpatient pharmacy, including 4 high-risk failure modes and 2 extremely high-risk failure modes. By regulating the process of drug doctor's advice, optimizing the implementation procedure of HIS information system and tablet dispensing machine, revising and improving the system, and training pharmacists and nurses, the mean RPN of 13 failure modes decreased from 38 to 15, with a decrease of 60.53%. The risk of four high risk failure modes was significantly reduced after improvement, and the difference was statistically significant (P < 0.05). Conclusion The application of FMEA in the risk management of drug dispensing process in inpatient pharmacy can effectively reduce the problems of drug loss, machine error, information docking error between HIS system and tablet machine, more drug taking times and long waiting time in the process of drug disassembly, improve the timeliness and accuracy of drug dispensing, and better serve the hospitalized patients.

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