Cov Haujlwm ntawm Kws Muag Tshuaj hauv Tsev Kho Mob Muag Tshuaj
Lub tsev muag tshuaj hauv tsev kho mob yog ib chav pabcuam kev pabcuam kho mob uas ua lub luag haujlwm tseem ceeb hauv kev ua kom muaj kev nyab xeeb, ua haujlwm tau zoo, thiab muaj laj thawj. Cov kws muag tshuaj ua haujlwm tseem ceeb hauv lub tsev muag tshuaj, lub luag haujlwm rau kev tswj hwm tshuaj thiab kev koom tes ncaj qha rau hauv cov kev pabcuam tshuaj hauv tsev kho mob. Kev txhim kho kev kho mob niaj hnub no xav kom cov kws muag tshuaj ua haujlwm tsis yog "tom qab qhov xwm txheej" tswj kev xa tshuaj xwb, tab sis kuj koom tes nrog cov kws kho mob, cov kws tu mob, thiab lwm tus kws tshaj lij kev kho mob kom ntseeg tau tias txhua tus neeg mob tau txais tshuaj kom raug, raws li qhov ntau npaum li cas, thiab nrog txoj kev siv tshuaj kom raug. Tsab xov xwm no tham txog cov luag haujlwm ntawm cov kws muag tshuaj hauv tsev kho mob, suav nrog kev tswj hwm, kev kho mob, qhov zoo, thiab kev nyab xeeb ntawm tus neeg mob.
1. Kev Tswj Xyuas Cov Khoom Siv Tshuaj (Kev Tswj Tshuaj)
Ib qho ntawm cov luag haujlwm tseem ceeb ntawm cov kws muag tshuaj hauv tsev kho mob yog tswj cov khoom siv tshuaj kom ntseeg tau tias muaj tshuaj thiab tswj lawv siv. Kev tswj hwm no suav nrog ntau yam haujlwm, txij li kev npaj thiab kev yuav khoom mus txog kev txais, kev khaws cia, kev faib tawm, thiab kev tshaj tawm.
Thaum lub sijhawm npaj, cov kws muag tshuaj xaiv cov tshuaj raws li cov ntawv teev tshuaj hauv tsev kho mob , cov qauv kab mob, cov ntaub ntawv noj, thiab cov peev nyiaj. Kev npaj kom zoo yuav tiv thaiv kom tsis txhob muaj cov khoom seem thiab cov khoom khaws cia uas yuav ua rau tas sij hawm. Thaum lub sijhawm yuav khoom, cov kws muag tshuaj xyuas kom cov txheej txheem yuav khoom ua raws li cov cai, xaiv cov neeg muag khoom uas ntseeg tau, thiab muab qhov tseem ceeb rau qhov zoo thiab kev cai lij choj ntawm cov khoom. Thaum tau txais cov khoom, cov kws muag tshuaj xyuas qhov ntau thiab tsawg, tus lej ntawm cov khoom, hnub tas sij hawm, qhov xwm txheej ntawm cov khoom ntim, thiab cov ntaub ntawv txhawb nqa.
Kev khaws cia kuj tseem ceeb heev. Cov kws muag tshuaj npaj ib txoj kev khaws cia uas ua tau raws li qhov yuav tsum tau ua, suav nrog kev sib cais cov tshuaj LASA (zoo li-zoo li-suab-zoo li), cov tshuaj ceev faj siab , cov tshuaj yeeb thiab cov tshuaj psychotropics, thiab cov tshuaj uas xav tau kev sib cais. Ntxiv mus, qhov kev npaj no ua raws li txoj cai FEFO (thawj zaug tas sij hawm, thawj zaug tawm) kom cov tshuaj uas yuav luag tas sij hawm raug xaiv ua ntej siv. Thaum lub sijhawm faib khoom, cov kws muag tshuaj xyuas kom meej tias cov tshuaj tau faib tawm kom muaj kev nyab xeeb, tsim nyog, thiab sau tseg zoo, txawm tias los ntawm cov txheej txheem ib zaug, cov khoom hauv pem teb, lossis cov kev pabcuam sau ntawv rau tus kheej.
2. Kev Pab Cuam Sau Tshuaj thiab Muab Tshuaj Kom Muaj Kev Nyab Xeeb
Cov kws muag tshuaj hauv tsev kho mob cov khw muag tshuaj yog lub luag haujlwm rau cov txheej txheem sau ntawv yuav tshuaj, suav nrog kev txheeb xyuas, npaj, thiab muab tshuaj rau cov neeg mob sab nraud thiab cov neeg mob hauv tsev kho mob. Kev txheeb xyuas daim ntawv yuav tshuaj muaj ntau dua li kev txheeb xyuas seb puas muaj tshuaj; nws kuj tseem ntsuas qhov tsim nyog ntawm kev kho mob: kev qhia, koob tshuaj, txoj kev siv, zaus, lub sijhawm, thiab kev sib cuam tshuam ntawm cov tshuaj, kev ua xua, thiab kev kho mob rov ua dua.
Thaum daim ntawv yuav tshuaj raug pom zoo lawm, tus kws muag tshuaj yuav xyuas kom meej tias cov txheej txheem muab tshuaj ua raws li cov qauv: kev npaj tshuaj, daim ntawv lo kom meej, thiab cov ntaub ntawv pov thawj kom raug. Yog tias pom muaj teeb meem, tus kws muag tshuaj yuav tsum piav qhia lossis cuam tshuam nrog tus kws kho mob sau ntawv. Lub luag haujlwm no pab txo qhov yuam kev ntawm kev siv tshuaj, tshwj xeeb tshaj yog rau cov tshuaj uas muaj kev pheej hmoo siab xws li insulin, anticoagulants, chemotherapy, thiab concentrated electrolytes.
3. Cov Kev Pabcuam Tshuaj Kho Mob
Hauv kev xyaum niaj hnub no, cov kws muag tshuaj hauv tsev kho mob muaj lub luag haujlwm dav dua hauv kev kho mob. Cov kws muag tshuaj ua lub luag haujlwm hauv kev saib xyuas kev kho mob, xyuas kom cov neeg mob tau txais cov tshuaj uas haum rau lawv tus mob, thiab saib xyuas cov lus teb thiab cov kev mob tshwm sim.
Cov kws muag tshuaj tuaj yeem koom nrog kev mus ntsib nrog pab pawg kho mob rau cov neeg mob hauv tsev kho mob. Thaum lub sijhawm mus ntsib no, cov kws muag tshuaj muab cov lus qhia txog kev xaiv tshuaj, kev hloov kho koob tshuaj rau cov neeg mob uas muaj teeb meem raum lossis siab, kev kho mob nrog tshuaj tua kab mob, kev tswj qhov mob, thiab kev tiv thaiv cov teeb meem sab nraud. Cov haujlwm no pab txhim kho qhov zoo ntawm kev kho mob thiab ua kom cov neeg mob zoo dua. Cov kws muag tshuaj kuj muab kev sab laj tshwj xeeb, piv txwv li, rau cov neeg mob uas muaj mob ntev xws li ntshav qab zib, ntshav siab, lossis mob hawb pob, kom ntseeg tau tias siv tshuaj ntau dua thiab ua tiav cov hom phiaj kho mob.
4. Cov Kev Pabcuam Qhia Txog Tshuaj (PIO)
Lwm lub luag haujlwm tseem ceeb ntawm cov kws muag tshuaj yog muab cov ntaub ntawv tshuaj tseeb, hloov tshiab, thiab muaj pov thawj. Cov kws kho mob, cov kws tu mob, thiab cov neeg mob xav tau cov ntaub ntawv tshuaj txog kev noj tshuaj, yuav siv li cas, cov kev mob tshwm sim, kev tsis pom zoo, kev ruaj khov ntawm kev noj tshuaj, thiab kev sib haum xeeb ntawm cov tshuaj (piv txwv li, txog cov tshuaj txhaj uas yuav sib xyaw).
Cov kws muag tshuaj tswj cov chaw qhia txog tshuaj lossis ua haujlwm no hauv lawv cov haujlwm txhua hnub. Thaum cov neeg ua haujlwm kho mob muaj lus nug txog cov kev xaiv kho mob, cov kws muag tshuaj tuaj yeem sab laj nrog cov ntaub ntawv tshawb fawb, cov lus qhia kho mob, lossis cov ntawv xov xwm thiab muab cov lus qhia txhim khu kev qha. PIOs kuj suav nrog kev kawm txog kev siv tshuaj tua kab mob kom zoo, qhov txaus ntshai ntawm kev siv tshuaj yam tsis muaj daim ntawv yuav tshuaj, thiab yuav ua li cas khaws cov tshuaj hauv tsev.
5. Kev Qhia thiab Kev Pab Tswv Yim rau Cov Neeg Mob
Cov kws muag tshuaj muaj lub luag haujlwm los qhia cov neeg mob kom lawv nkag siab txog cov tshuaj uas lawv noj. Feem ntau, kev qhia txog lub hom phiaj ntawm kev kho mob, kev noj tshuaj thiab lub sijhawm, cov lus qhia rau kev siv (ua ntej/tom qab noj mov), yuav siv cov khoom siv li cas (piv txwv li, cov tshuaj nqus pa, cov cwj mem insulin), thiab cov cim ceeb toom ntawm cov kev mob tshwm sim.
Qhov kev qhia no tseem ceeb heev rau cov neeg mob uas tau txais kev kho mob nyuaj, cov neeg laus, cov neeg uas noj ntau yam tshuaj (polypharmacy), lossis cov neeg uas muaj feem yuav tsis ua raws li kev noj tshuaj. Nrog kev qhia tswv yim zoo, cov kws muag tshuaj tuaj yeem pab txhim kho kev ua raws li kev noj tshuaj, tiv thaiv kev ua yuam kev ntawm kev noj tshuaj, thiab txo qhov feem pua ntawm kev rov qab mus rau tsev kho mob lossis rov qab mus rau tsev kho mob.
6. Kev Tswj Xyuas Zoo, Kev Nyab Xeeb ntawm Tus Neeg Mob, thiab Kev Saib Xyuas Tshuaj
Cov kws muag tshuaj ua lub luag haujlwm tseem ceeb hauv cov kev pab cuam kev nyab xeeb ntawm tus neeg mob, tshwj xeeb yog kev nyab xeeb ntawm cov tshuaj. Cov kws muag tshuaj koom nrog kev tsim thiab siv cov txheej txheem ua haujlwm tus qauv (SOPs) ntsig txog kev khaws cia, kev faib tshuaj, thiab kev muab tshuaj, nrog rau kev tshaj tawm cov xwm txheej kev nyab xeeb. Cov kws muag tshuaj kuj koom nrog kev txheeb xyuas thiab tiv thaiv kev ua yuam kev ntawm cov tshuaj los ntawm kev kuaj xyuas ob zaug, kev cais cov tshuaj qee yam, thiab kev siv cov ntawv ceeb toom.
Ntxiv mus, cov kws muag tshuaj ua cov kev ceev faj txog kev siv tshuaj, uas yog kev saib xyuas thiab tshaj tawm txog cov tshuaj tsis zoo (ADRs). Thaum pom muaj tshuaj tsis zoo , cov kws muag tshuaj sau tseg qhov xwm txheej, ua qhov kev ntsuam xyuas qhov ua rau, thiab tshaj tawm rau lub kaw lus tshaj tawm tsim nyog. Qhov kev ua no yog qhov tseem ceeb rau kev txhim kho kev nyab xeeb ntawm kev kho mob hauv tsev kho mob thiab txhawb nqa kev saib xyuas tshuaj hauv tebchaws.
7. Kev Sib Xyaws Uas Muaj Sterile Thiab Tsis Muaj Sterile
Hauv qee lub tsev kho mob, cov kws muag tshuaj muaj lub luag haujlwm rau kev sib xyaw cov tshuaj, ob qho tib si tsis yog sterile (piv txwv li, hmoov thiab tshuaj pleev sib xyaw) thiab sterile (piv txwv li, kev noj zaub mov parenteral, cytotoxic npaj, thiab qee cov tshuaj txhaj tshuaj sib xyaw). Kev sib xyaw sterile xav tau cov chaw tshwj xeeb thiab cov txheej txheem, xws li chav huv thiab laminar flow cabinets (LAFs / BSCs), kom ntseeg tau tias cov khoom tseem sterile thiab muaj kev nyab xeeb.
Cov kws muag tshuaj xyuas kom meej tias kev sib xyaw ua ke raug ua raws li GMP cov ntsiab cai / cov qauv cuam tshuam, them sai sai rau kev ruaj khov, kev sib xws, thiab kev ntsuas qhov tseeb. Qhov no yog qhov tseem ceeb vim tias txawm tias qhov yuam kev me me hauv kev sib xyaw, tshwj xeeb tshaj yog rau kev kho mob chemotherapy lossis kev noj zaub mov parenteral, tuaj yeem ua rau cov neeg mob tuag taus.
8. Kev Tswj Xyuas Cov Tshuaj thiab Kev Tswj Tshuaj Tua Kab Mob
Daim ntawv teev cov tshuaj hauv tsev kho mob yog daim ntawv teev cov tshuaj uas tau pom zoo siv hauv tsev kho mob raws li kev ua tau zoo, kev nyab xeeb, thiab tus nqi. Cov kws muag tshuaj ua haujlwm hauv pawg neeg muag tshuaj thiab kho mob (PFT), uas soj ntsuam cov tshuaj hauv daim ntawv teev cov tshuaj, txiav txim siab txog cov qauv siv, thiab tsim cov cai.
Nyob rau hauv cov ntsiab lus ntawm kev nce ntxiv ntawm kev tiv thaiv tshuaj tua kab mob, cov kws muag tshuaj kuj ua lub luag haujlwm hauv cov kev pab cuam tswj kev tiv thaiv kab mob, uas tswj kev siv tshuaj tua kab mob kom tiv thaiv kev siv ntau dhau lossis tsis tsim nyog. Cov kws muag tshuaj pab xaiv cov tshuaj tua kab mob tsim nyog, soj ntsuam qhov xav tau kev txo qis, hloov kho cov koob tshuaj, thiab txhawb kom kuaj kab mob thaum tsim nyog.
9. Kev Tswjfwm, Kev Tshaj Tawm, thiab Kev Txhim Kho Kev Pabcuam
Cov hauj lwm ntawm cov kws muag tshuaj suav nrog kev tswj hwm thiab kev tshaj tawm, xws li sau cov tshuaj siv, cov ntawv qhia txog tshuaj yeeb thiab tshuaj psychotropic, kev ntsuam xyuas cov khoom lag luam, thiab kev tshuaj xyuas tus nqi tshuaj. Cov kws muag tshuaj kuj tsim cov kev pabcuam, xws li kev siv cov thev naus laus zis tshuaj, e-prescribing, unit dose systems, thiab cov kev pab cuam tswj kev kho mob siv cov ntaub ntawv.
Cov kws muag tshuaj kuj ua lub luag haujlwm hauv kev kawm thiab kev tshawb fawb. Hauv kev qhia ntawv hauv tsev kho mob, cov kws muag tshuaj cob qhia cov neeg xyaum ua haujlwm, cov kws muag tshuaj xyaum ua haujlwm, thiab cov kws tshaj lij hauv kev muag tshuaj. Kev tshawb fawb ntsig txog kev siv tshuaj, kev ntsuam xyuas kev kho mob, thiab kev txhim kho zoo kuj pab txhawb rau kev txhim kho cov kev pabcuam hauv tsev kho mob.
Xaus
Cov hauj lwm ntawm cov kws muag tshuaj hauv tsev kho mob yog dav thiab muaj txiaj ntsig zoo, suav nrog kev tswj hwm tshuaj, kev pab sau ntawv yuav tshuaj, kev pab cuam tshuaj hauv tsev kho mob, cov ntaub ntawv txog tshuaj, kev qhia rau tus neeg mob, kev saib xyuas zoo thiab kev nyab xeeb, kev sib xyaw ua ke, thiab lub luag haujlwm hauv cov pawg neeg thiab cov kev pab cuam tswj tshuaj tua kab mob. Los ntawm kev txawj ntse thiab kev koom tes ntawm cov kws tshaj lij, cov kws muag tshuaj pab ua kom muaj kev siv tshuaj zoo, muaj kev nyab xeeb, thiab siv tau zoo. Kev muaj cov kws muag tshuaj hauv tsev kho mob yog lub hauv paus tseem ceeb rau kev txhim kho kev nyab xeeb ntawm tus neeg mob thiab qhov zoo ntawm cov kev pab cuam kho mob.
