Effectiveness And Economic Evaluation Of Dynamic Posts In Pharmacy Intravenous Admixture Services In Our Hospital

Background: In most domestic hospitals,especially for Pharmacy Intravenous Admixture Services(PIVAS)in the Grade-A tertiary hospital,the quantities of infusion configuration are large and the methods of configuration are mostly manual methods,that means there are many issues in PIVAS,such as the shortage of manpower,the intensity of labor,occupational injuries and so on.In order to solve these issues,our hospital adopted two solutions: The first is to add fixed configuration posts in PIVAS,which is on the basis of the original post staff,more staff are assigned to meet the needs of daily infusion configuration work in PIVAS.The second is to set up dynamic posts.Dynamic posts were applied in PIVAS instead of increasing more fixed posts.Nursing staff and pharmacists in the hospital can do a part-time job of infusion configuration in PIVAS in their spare time on the basis of fulfilling their own duties,so as to solve the shortage of configuration’s staff at peak times and meet the daily configuration requirements.Objective: In this study,the health measurement scale SF-36(Chinese version)was conducted to investigate the life quality of the staff who participated in dynamic post and those who did not participate in dynamic post,in order to evaluate the effects of the implementation of dynamic post on the health status of the staff in hospitals.From the perspective of hospital,by comparing the costs and effects of setting up dynamic posts and increasing fixed posts,this survey was used to evaluate the economy of applying dynamic posts in PIVAS of our hospital,with a view to solving the shortage of human labor in PIVAS during the peak period and reducing costs through dynamic posts.It provides some reference basis for the healthy operation of PIVAS in hospital.Methods: Investigate the changes in appearance,p H value,turbidity,number of insoluble particles of the finished infusion solution within 6h at room temperature to compare the quality of the finished infusion solution configured by the dynamic and fixed post stuffs.Secondly,the SF-36 health survey scale was used to conduct a questionnaire survey on the part-time dynamic and fixed post staffs to evaluate the life quality and health status of the staff in eight dimensions,including physiological function,physiological function,physical pain,general health,energy,social function,emotional function and mental health.Thirdly,compare the economy of dynamic and fixed posts in PIVAS by evaluating the costs and effects from the perspective of hospitals,and conduct the one-sensitivity analysis to verify the robustness of the results.Results: 1.Quality test results of finished infusion: The test results of the appearance traits,PH,clarity and insoluble particles of the finished infusion were within the standard range of infusion in the Chinese Pharmacopoeia.2.SF-36 Health Survey Scales: except for the two dimensions of physiological function and mental health,the score of part-time dynamic post was higher than that of non-part-time dynamic post(physiological function:dynamic post: 83.03±11.92 VS 79.20±11.12;Mental health: dynamic post: 60.66±12.36 VS 58.00±10.66),the scores of the other 6 dimensions were lower.There were significant differences in 5 dimensions of physiological function,physiological function,physical pain,social function and emotional function(P<0.05),but no significant differences in 3dimensions of general health,energy and mental health(P>0.05).The scores of part-time mobile posts were also lower than those of non-part-time mobile posts in terms of total physical health measurement and total mental health measurement,with statistical significance(P>0.05).3.Economic analysis results: the cost analysis results showed that the cost per bag of drugs allocated in dynamic post was lower than that in fixed post(dynamic post: 1.51 yuan per bag VS fixed post: 1.82 yuan per bag).The results of effect analysis showed that the unit time of dispensing each bag of drugs in dynamic post was less than that in fixed post(dynamic post: 1.03 min per bag VS fixed post: 1.73 min per bag).The ICER value of cost-effectiveness analysis was 0.92 yuan,and the sensitivity analysis showed that the number of antibiotic bags,the number of fixed posts,the annual salary of fixed posts,the total number of dynamic posts and the total number of fixed posts had the greatest influence on the model,while the price of chemotherapy drugs,the number of chemotherapy bags,the price of parenteral nutrition and the number of parenteral nutrition bags had little influence on the model.Conclusions: 1.The quality of the finished infusion dispensed by the two groups conforms to the quality standard of Chinese Pharmacopoeia,ensuring the safety and effectiveness of the drugs.2.The optional and extra salary of dynamic positions can stimulate the work enthusiasm of medical staff and improve work efficiency,but at the same time,part-time jobs occupy the rest time of staff and affect their health.3.The establishment of dynamic posts is more economical than the increase of fixed posts,but there are many factors affecting the results,so many factors should be taken into account when making program planning.