Zero-opening drug management needs to be standardized

The “zero-opening drug” refers to a drug used by a hospital pharmacist after dismantling the drug in its original packaging when it is dispensed according to the prescription dosage of the doctor. In actual operation, the zero-clearing of drugs is divided into two cases: breaking the minimum packaging unit and keeping the minimum packaging unit. The zero-opening drugs that destroy the smallest packaging unit should be stored centrally in the zero-clearing drug counter, and the zero-clearing records should be made. The zero-clearing drugs (such as injections) that retain the smallest packaging unit can be centrally stored in the zero-clearing drug counter, or they can be stored in the original counter and be used as Good to remove the zero record. At present, some medical institutions, especially grass-roots ones, have not standardized the management of unrolled drugs. This will cause hidden dangers in drug safety.

There is a lack of knowledge in the management of the unpacked drug. Some pharmacists in the hospital lack pharmacy knowledge. The definition of the unpacked drug is not clear. The drug is not well-understood in terms of traits and functions, and the clinical application is not well understood. The pharmacist manages the unpacked drug. Indifferent consciousness has brought greater security risks and economic losses to the management of unzipped drugs. The lack of awareness of the zero-clearance drug administration will first make it difficult to guarantee the quality of the drug. The medicine-loaded medicine pan enters the ward through the outdoors without a cover. Because the medicine is exposed to the air for a long time, redox reactions may occur, resulting in a decrease in the content, a change in the color of the liquid preparation, and decomposition of impurities. The increase in the content has seriously affected the safety and effectiveness of the patient's medication. Secondly, because the turnover rate of inpatients using drugs is relatively fast, the pharmacy personnel often disassemble the same oral drug and concentrate it in a grinding mouth bottle, or place the injection in a pill box or a drawer. Therefore, different manufacturers and batch numbers are required. Drugs are mixed together, increasing the probability of drug expiration and mis-delivery. In addition, the zero-clearing of drugs is determined according to the needs of the hospital doctors' prescriptions, and it is not necessary to remove the drugs only for the sake of a single formula. Therefore, the pharmacist must first communicate with the physician before the drugs are removed to ensure that the zero-opened drugs will not be removed. Wasting loss.

There are special requirements for storage of unpacked medicines. Some of the unpacked medicines have special requirements for storage. For example, shading, oxidation prevention, refrigerating, and moisture proofing are required. Since the original packaging is dismantled, the probability of changes in the quality of such medicines is increased. For a long time, unopened medicines that are not used up are susceptible to oxidation, moisture, and moisture, resulting in a decrease in the content of tablets and the appearance of spotting and dissolution of capsules. It is also easy to neglect the management of the validity period of the remaining drugs, and the number of such drugs after the removal of zero is small, and it is impossible to use detection methods to identify the unqualified drugs.

The zero-opening medicine bag should first conform to the provisions of the medicine packaging materials, and indicate the sales unit, product name, specifications, usage, dosage, production batch number and expiration date on the medicine bag. However, because of the lack of a unified regulatory requirement, the zero-opening kits used in many hospital pharmacies cannot fully label the above. Some hospital pharmacists did not even write anything on the unpacking kit. The customer did not know the use and validity of the unpacked product. There is a wide variety of packaging materials, including kraft paper bags, white paper bags, plastic bags, plain paper or newspapers, and even disposable syringe bags serving as medicine bags. The unstandardized packaging materials and logos have caused great safety risks to the formula sales and use of medicines in hospital pharmacies.

The records of unpacked drugs are not clearly defined. According to the provisions of the “Prescription Management Regulations” promulgated by the Ministry of Health of the People's Republic of China, the amount of regular prescriptions must not exceed 7 days, and the emergency prescriptions must not exceed 3 days. The pharmacies are bound to dispense prescriptions. There will be zero drug release. Under normal circumstances, the pharmacy personnel remove the drug and mark the usage and dosage directly. However, information on the drug's name, specifications, when it failed, and special precautions were not known. Once the patient takes the drug and produces adverse drug reactions or quality problems in the drug, and then traces relevant information, not only the hospital is particularly passive, but also does not meet the requirements of relevant laws and regulations. Therefore, according to the relevant regulations, the zero-clearing drugs must establish a zero-clearing sales record so as to timely acquire the source of the unpacked drugs and the whereabouts of the sales, and ensure the safe use of the unpacked drugs. At present, many hospital pharmacies have not established a zero-clearing record. Once the zero-clearing drugs have quality problems, it is difficult to identify the “identity” and sales flow of drugs in a timely manner.

Zero Sanitation Environment Sanitation Unsanitary Ward “Dosing Drug Room” is a studio of the medical unit's ward pharmacy and is responsible for the formulation and distribution of oral single-dose drugs for patients in the entire ward. As far as its environment is concerned, some hospitals do not have a dedicated drug room, but are mixed with outpatient pharmacies, offices, restrooms, duty rooms, and drug stores. When the medicine is placed, the doors and windows are open, and the personnel walk freely; the sanitation medicine cabinet is cleaned regularly, and all the medicines on the operating table are unpacked, surrounded by debris and office supplies, and some hospital wards pharmacies also place placed medicines. Corridor aisle.

Standardized operation to reduce potential safety hazards to strengthen the responsibility of pharmacists to remove zero-responsive drugs Zero-opening drugs are inexpensive and easy to use, can adapt to the needs of clinical medicine and customer medication, and make rational use of drug resources. Therefore, it is necessary for hospitals to carry out the combined sales of zero-clearing drugs. In order to allow the masses to rationally use convenient and safe zero-opening drugs, it is important to strengthen the training of the knowledge of the hospital pharmacists in the zero-opening drugs and to improve the pharmacists' professional quality and management skills. Medical institutions should formulate corresponding work responsibility systems to improve pharmacists' understanding of the importance of zero-opening drug management, and can further strengthen the pharmacy personnel's sense of responsibility for the checking of zero-opened drugs and reduce the error rate.

Standardize the operation of zero-clearing drugs first, and regulate the zero-opening medicine bags. The zero-opening medicine bag should conform to the provisions of the medicine packaging materials, and indicate the sales unit, product name, specifications, usage, dosage, production batch number and validity period on the medicine bag. Non-prescription drugs must be affixed with labels and instructions for each basic unit of sales; the zero-span and short-lived drugs should be given to the purchaser to clarify the expiration date of the drug and be noted on the drug bag to indicate that the patient will not expire within the time of use.

Second, build a record of zero removal. The hospital pharmacy should establish a corresponding sales record for drug zero removal; at the same time, it should combine with the purchase and sales records of drugs to accurately control the source and whereabouts of the zero-opening drugs. The zero-removal record should generally include the following items: the date of start and end of demolition, product name, dosage form, specification, lot number, validity period, remaining quantity, production enterprise, quality status, handling person, etc.

Third, regulate operating behavior. The pharmacist must standardize and optimize the zero-clearing operation procedure to minimize the human contamination of the drug during the zero-clearing process and ensure the quality of the unzipped drug. Before removing the zero, check the quality of the package and appearance of the unpacked product. Use the ready-to-use, ready-to-use, and keep the original package and label instructions until the batch of the drug is sold; when the medicine is used in the unpacking, the product should be operated in a zero-clearing place that meets the hygienic conditions. , And to maintain the cleanliness and hygiene of the cabinets or consoles and utensils; after unpacking, the medicines should be stored in the counter at zero, and should not be mixed with other medicines. If the medicines cannot be kept in the original packaging, they must be put into the unpacking medicine bags. , affixed with the label to remove zero; issued zero-clear drug, the drug should be written on the generic name, dosage form, specifications, usage, dosage, batch number, validity period and sales unit.

The establishment of a zero-opening drug zone hospital pharmacy meeting the requirements requires the establishment of a “zero-opening drug zone” requirement. Medical institutions at all levels shall purchase relevant facilities and equipment according to the number of beds in the hospital, design an operation space suitable for the sale of zero-opened drugs, and set a dressing buffer. Districts, operating rooms should be equipped with air conditioning, medicine cabinets, dust curtains, UV lights, swivel chairs, special slippers and other facilities; equipped with a special zero-clearing tools, such as spoon, knife, split bag, balance, medical gloves, etc., set to remove zero Drug shelves and consoles; zero-opening drugs should be stored centrally in the demolition area, and the drugs must be placed on the original shelves. The pans should all be fitted with lids.

Efforts to solve the storage conditions of drugs should be strictly enforced according to the preservation conditions of drugs, special preservation of the zero-clearing drugs should be equipped with refrigerators and light protection facilities to ensure that the drug storage conditions meet the requirements. In addition, when the effective period of the drug changes its original packaging and is placed in other containers, its expiration date should be recorded in a new container so that it can be checked for expiration at any time. Different batches of drugs can not be mixed to prevent overdue expiration, when expired. For some moisture-sensitive and easily oxidized drugs, they should be used centrally, so that the drugs after opening can be used up in the shortest time, reducing or avoiding unfixed multiples; the quality of some of the drugs that are susceptible to external factors, such as instability, appearance after opening Drugs that undergo changes in traits should be reported in a timely manner. Drugs that require cryogenic storage should not be stored at room temperature before and after zero removal. For drugs that have been used for a long time after they have been removed, they should be frequently inspected and managed.