桑文涛 余芳蓉 李波 罗学虎 段杰 吴瑶

[摘要] 通过收集成都市郫都区人民医院门诊和住院西药房2017年1～12月登记的近效期药品资料进行统计分析，确定改善重点是注射剂和口服制剂，且近效期注射剂中重点管理急抢救注射剂药品。通过从药房人员、方法、设备、材料、医师5个方面解析导致近效期药品过多的原因，并进行原因分析问卷调查，得出导致近效期药品过多最主要的5种原因：个别科室申请的药品未及时使用或使用率较低;拆零药品不易管理，疏于检查效期;个别药品更换包装或厂家致少量剩余药品调配不出去;未及时检查近效期药品;急抢救药品使用频率低，管理欠佳和个别药物更新周期长。依据现状和原因分析，从完善管理制度、强化具体管理和加强教育培训三方面进行解决措施探讨，旨在减少近效期药品的产生，保证药品质量，确保临床用药安全，避免药品资源浪费。

[关键词] 近效期;药品;现状;原因;措施

[中图分类号] R952          [文献标识码] A          [文章编号] 1673-7210（2019）01（c）-0155-05

[Abstract] Through collecting the data of the nearly valid drugs registered in the Outpatient and Hospitalized Pharmacy Department of Pidu District People′s Hospital of Chengdu City from January to December 2017 to analyze， it is determined that the key improvement is the injection and oral preparation， and the key management of the injection in the nearly valid is to manage the emergency injection preparation. This paper analyzes the causes leading to so many nearly valid drugs on pharmacy personnel， methods， equipment， materials and physicians five aspects， and the cause analysis questionnaire is carried out. The five main causes leading to so many nearly valid drugs： the drugs applied in individual clinical department are not used in time or the use rate is low; the dismantling drugs are not easy to manage; a few drugs for replacing packages or manufacturers leading to have a small amount of residual drugs not to be dispensed out; the nearly valid drugs are not timely inspected; the low use rate and poor management of emergency medicine; a long period of renewing of individual drug. According to the analysis of the present situation and causes， this paper discusses the measures in three aspects on improving the management regulations， strengthening the specific management and strengthening the education and training of relevant personnel， aiming at reducing the production of the nearly valid drugs， ensuring the quality of the drugs， ensuring the safety of the clinical medication and avoiding the waste of the drug resources.

[Key words] Nearly valid; Drugs; Status quo; Causes; Measures

藥品的“有效期”是指药品在规定的储存条件下能够保证质量的期限，《中华人民共和国药品管理法》第49条第三款中明确规定：未标明有效期或者更改有效期或者超过有效期的按劣药论处。若药师将过期药品发出，一般按销售劣药处理;造成医疗事故的将按照《医疗事故处理条例》鉴定的事故等级进行赔偿，并追究相关责任人的责任[1]。近效期药品含义为：距药品有效期截止日期不足6个月的药品。……