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医用耗材管理工作量大?一个二维码全搞定

2018-03-27 吴清、孙冬杰、庞浩 中国卫生质量杂志

利用二维条形码技术,可以大大提高耗材管理的效率并减轻科室劳动强度。

医用高值耗材指的是医疗器械中直接作用于人体、对安全性有严格要求、临床使用量较大、限于某些专科使用且价格相对高昂的消耗性医疗器械。随着医疗事业的快速发展,高值耗材的使用量越来越大,对医用高值耗材管理规范化和科学化的要求也越来越高。如何利用数据库技术提高医用耗材的管理水平,转变管理模式,优化管理流程,确保医用高值耗材在医疗服务中的安全性、可靠性和有效性,已经成为设备管理部门关注的重点。

1 传统医用高值耗材管理方法存在的问题

随着医用高值耗材的使用量越来越大,传统的医用高值耗材管理方法暴露出了一些问题。

1.1 工作量大和工作效率低

传统医用高值耗材需要库房管理人员通过手动输入编码来实现耗材的入库和出库管理。随着耗材使用数量和种类的增加,出入库管理工作大幅增加,而库房管理人员却没有相应增加,导致库房管理的效率降低。

1.2 出入库差错率较高

传统医用高值耗材管理需要库房管理员在耗材入库和出库时准确填写物资的产品名称、型号规格、单价、数量、批号以及代理商名等信息,为保证医用高值耗材使用的可追溯性,耗材的生产批号、产品出厂编号作为耗材溯源管理的重要标识必须准确无误。但由于生产批号和出厂编号比较复杂,数字和字母相交叉,在耗材出入库时很容易出差错;而出错将导致耗材的溯源管理无法进行,须重新检查录入,增加了耗材管理的工作量。

1.3 耗材的使用情况和溯源性不明晰

传统的医用高值耗材管理流程是由临床科室先向器材管理部门发出采购申请,器材管理部门收到申请后通知供应商配送耗材,由保管员验收耗材并填写手工验收单,供应商持单将耗材送至申请科室,科室术后填写使用记录单交给器材管理部门,器材管理部门通知供货商开具发票。在这种管理模式下,病人实际使用的是否是医院已验收产品、产品是否用到病人身上,器材管理部门都不能及时、准确掌握。

2 二维条形码技术的应用

通过多年来的实践总结,同济医院器材管理部门自主研发了一套符合对高值耗材监管要求的、符合对高值耗材管理规定的、并可与现有HIS系统匹配的高值耗材监管系统,成功地把二维条形码技术应用到医用高值耗材管理当中。既满足了医生需要及时、快捷得到符合手术要求高值耗材的服务需求,又满足了医院对医用高值耗材溯源管理的要求。

2.1 二维条形码技术介绍

二维条码是用某种特定的几何图形按一定规律在平面上记录数据符号的信息。在代码编制上使用若干个与二进制相对应的几何形体来表示文字数值信息,二维条码能够在横向和纵向两个方位同时表达信息,通过图象输入设备或光电扫描设备可自动识读从而实现信息自动处理[4]。与传统条码技术相比,二维条形码技术具有存储容量大、编码范围较广、防伪性能好、译码可靠性高、抗损性大、容易制作且成本很低等特点。

2.2 二维条形码技术在医用高值耗材管理中的应用

以二维条形码自动识别技术为基础建立的高值医用耗材监控与管理系统,能够实现信息源、信息处理器和信息用户的自动化,不需要更多的人工介入,便可让高值耗材在医院流动,并能同步记录各种使用信息[5]。这一技术可以发挥二维条形码数据容量大、可用多种阅读设备阅读的特点,将高值耗材复杂的信息融入二维码中,不但利于计算机管理系统的录入,而且便于验收人员、医护人员的随时查询。极大地提高了高值耗材信息的准确程度,提高了管理效率[6],而且使高值耗材的选择和验收全过程公开、透明,杜绝了偷换、错用高值耗材以及伪劣产品流入医院。

2.3 关键步骤

利用二维条形码技术建立高值医用耗材监控与管理系统有三个关键步骤,分别是产品信息标准化,充分利用耗材包装上的条码信息以及管理部门验收和录入信息。

(1)产品信息标准化是指建立医用耗材信息统一的标准数据库。数据库中产品信息包括产品代码、品名、规格、单价、产品注册证号、生产许可证号、产品识别信息等。其中名称、规格必须与产品注册证、产品外包装上信息完全一致,这样的耗材信息标准化,才能便于管理部门验收,临床科室核对,及术后登记利用。

(2)充分利用耗材包装上的条码信息是指将产品出厂时外包装自带条码作为产品溯源依据,将这些条形码信息打印到送货单上,待录入送货单时一起录入到耗材管理程序中,为后续的耗材出库、产品溯源提供识别手段。

(3)管理部门验收和录入信息是指供应商将耗材送入医院前将耗材的基本信息转换成二维条码打印在送货单上,验收人员只需对照二维条码送货单上的文字信息验收耗材,验收后直接用扫描枪扫描送货单上的二维条码,就能将全部信息录入到耗材管理系统中。医院为供应商提供统一的送货单打印流程,供应商仅能在自己公司的招标品目内填写送货信息。供应商每次送货前需在送货系统界面填写的信息内容,包括耗材的数量、扫描编号、产品批号、失效期等内容。

3 基于二维条形码技术应用的高值耗材管理流程

一般请款下,医院根据医用耗材的不同属性,将医疗耗材分成了三类。第一类是普通低值耗材,第二类是需备用库存的高值耗材,第三类是不备存的高值耗材。

需备用库存的高值耗材二维条形码技术的管理流程为:(1)由信息系统根据前几个月的材料领用量和实际库存数初步计算出下月计划的采购量。(2)手术室护士长根据实际情况调整计划并反馈给二级库房管理员。(3)管理员通过微信平台通知各供应商供货。(4)供应商收到计划后,在送货单打印程序中填写完整供货信息,打印二级库专用送货单,生成二维码。(5)供应商送货时,将货品及打印好的二级库专用送货单交于库房管理员进行验收。(6)库房管理员扫描送货单上的二维码,系统读入送货单上的所有信息。(7)验收无误后,保存预入库信息,打印二级库入库单。(8)当手术室需要领物时,只需在出库窗口扫描产品外包装上的二维条码,系统便可自动减少预入库库存,打印二级库房出库单。

对于不备库存的高值耗材,预入库环节与需备用库存的高值耗材一致,不同的是,验收无误后,二类物资是留在手术室分库房留作库存,三类物资则是直接送去消毒然后进入手术室使用的,是不留在分库房作为库存的。手术结束后,由主刀医生、巡回护士及供应商确认手术中实际使用耗材的情况,然后由巡回护士根据已确认的实际使用数量为病人记账,打印《植入性器械使用登记表》并签字确认,一式四份,一份交于患者,一份夹于医疗记录中,一份交设备管理部门保管,一份交供应商。供应商根据《植入性器械使用登记表》上的信息,在送货单打印程序中填写耗材确认出库信息,打印二级库房耗材使用确认单,并生成二维码。供应商将耗材使用确认单交予二级库管理员,管理员核对《植入性器械使用登记表》与确认单以后,扫描使用确认单上的二维码出库,打印二级库出库单。需要说明的是,以上所讲的出库、入库都是预入库、预出库,不是正式财务上的入库、出库,不进行扣除预算以及计入科室成本的,因此系统需锁定正式入库的起止时间,以便每月在某一固定时间统计结算金额。这种预入库管理模式的优点在于,可以在财务上实现零库存[7]。

4 小结

《医疗器械监督管理条例》明确指出,医疗器械使用单位应当妥善保存购入第三类医疗器械的原始资料,并确保信息的可追溯性。高值耗材溯源管理医院医疗器械管理的重要要求,二维条形码技术是保证高值耗材溯源管理可行的重要手段。利用二维条形码技术,可以大大提高耗材管理的效率并减轻科室劳动强度。将高值耗材的复杂信息嵌入二维条码中实现了高值耗材从入库、出库到最终患者使用的全程跟踪管理,并可实现高值耗材的溯源管理,最终实现患者、供应商和医院三方利益都能得到有力保障。

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    2018-11-06 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2018-03-27 三生有幸9135

    学习一下谢谢分享

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