Abstract

Centralized intravenous admixture service (CIVAS) centres, which are pharmaceutical departments found in Chinese hospitals, provide high-quality intravenous fluids and pharmaceutical services for patients, and errors in their working procedures can lead to adverse consequences. Pharmacists, the primary CIVAS centre personnel, play a role in risk control; however, to date, the effect of pharmacists’ participation in risk management has not been reported. The main aim of this study was to evaluate the pharmacist’s role in risk control and evaluate its impact. A retrospective observational study was designed to assess the principal working process in the CIVAS centre of a provincial healthcare setting. Errors in the main working process were identified, and intervention measures were formulated. The pharmacist intervention effect was evaluated by assessing the identification rate of improper prescriptions; the incidence rate of drug preparation, compounding, packaging and delivery process errors; and expenditures on wasteful drugs. There was a higher identification rate for improper prescriptions after the intervention (P < 0.05), while the incidence of drug preparation (P < 0.05), admixture (P < 0.05), and packaging and delivery errors (P < 0.01) was significantly lower; the total wasteful medication expenditure was also dramatically reduced. The potential creativity of pharmacists in error control can provide dependable intravenous drugs for patients and reduce the running expenditures for CIVAS.

Highlights

  • Centralized intravenous admixture service (CIVAS) centres, which are pharmaceutical departments found in Chinese hospitals, provide high-quality intravenous fluids and pharmaceutical services for patients, and errors in their working procedures can lead to adverse consequences

  • The Ministry of Health of China has become aware that hospital pharmacies serving hospitalized patients should routinely prepare specialized intravenous compounds in a sterile and centralized setting, and the United States Pharmacopeia (USP) Chapter was consulted prior to the construction of centralized intravenous admixture service (CIVAS) c­ entres[2]

  • It is estimated that more than 1000 CIVAS centres have been established in first- or second-class Chinese hospitals; these centres have developed into an emerging pharmaceutical industry and a subdiscipline in hospital pharmacy ­science[1]

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Summary

Introduction

Centralized intravenous admixture service (CIVAS) centres, which are pharmaceutical departments found in Chinese hospitals, provide high-quality intravenous fluids and pharmaceutical services for patients, and errors in their working procedures can lead to adverse consequences. The pharmacist intervention effect was evaluated by assessing the identification rate of improper prescriptions; the incidence rate of drug preparation, compounding, packaging and delivery process errors; and expenditures on wasteful drugs. The potential creativity of pharmacists in error control can provide dependable intravenous drugs for patients and reduce the running expenditures for CIVAS. The utilization of multiple working processes poses a significant potential for errors, and additional staff are required to recheck drugs and operations, especially in the intravenous admixture preparation and labelling phase,.

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