Development of regional pharmacy intravenous admixture services data reporting and analysis platform for enhanced quality control ability

Intravenous drug therapy is widely used in clinical treatment in China. The percentage of inpatients receiving intravenous infusion exceeds 80% [1]. However, intravenous administration is considered the most risky method of drug therapy, as it can lead to severe adverse reactions and pose a threat to human life and health. According to the 2021 National Annual Monitoring Report on adverse reactions, 55.3% of adverse reactions are attributed to injection administration, with 90.5% of these adverse reactions specifically related to intravenous administration [2].

Pharmacy intravenous admixture services (PIVAS) is a department within medical institutions that provides specialized technical services for the centralized compounding of intravenous medications for patients. In PIVAS, trained pharmacists offer pharmaceutical services such as intervention and review of intravenous medication prescriptions, compounding and mixing of medications, and participation in the assessment of intravenous infusion usage [3, 4]. Studies have indicated that the implementation of PIVAS can significantly improve the level of rational drug use, enhance infusion safety, and reduce occupational exposure among healthcare workers [5, 6]. Additionally, it has been shown to decrease medication preparation errors and result in cost savings [7]. PIVAS has been widely adopted in developed countries such as the United States, Canada, Australia, New Zealand, and the United Kingdom [8‐10]. In China, over 2,000 PIVAS have been implemented. However, it is important to emphasize that PIVAS is a high-risk institution. Inadequate hardware, unreasonable dispensing processes, and chaotic personnel management can lead to large-scale and unforeseen drug accidents. Abdulwahid and Al-Ani. (2020) collected 99 cases from five hospitals. Among these cases, 52 were drug accidents caused by improper use of intravenous injection include drug-drug interaction, drug-disease interaction, and not indicated medication [11]. Curran. (2011) found that infusate contamination can cause infusate-related bloodstream infection and even death [12]. Moyen. et al. (2008) discovered drug errors rank seventh in terms of causes of death [13].

At present, many studies have shown the importance of information management in pharmacy administration. A study by Mazrouei. et al. (2021) showed that standardized data collection is conducive to reduce over-the-counter drug abuse [14]. Meslamani. et al. (2021) showed that pharmacists’ remote intervention through telephone and Internet impact on the medication and clinical outcomes of patients with COVID-19 in rural areas [15]. Abdel-Qader. et al. (2022) showd that online collaborative consultation between pharmacists and doctors significantly reduce people’s resistance to the COVID-19 vaccine [16]. Although various intelligent machines and systems have been implemented in PIVAS, including labeling systems, infusion sequence annotation systems, review prescription databases, and so on [17‐19], the utilization of this equipment only addresses workload challenges and helps mitigate human errors in specific aspects of the workflow. At present, there is little research on the standardized capability and risk evaluation of PIVAS by using modern information technology. In this research, we established the Regional Pharmacy Intravenous Admixture Services Data Reporting and Analysis Platform (RPDRAP), based on guidelines for the Construction and Management of PIVAS and management specifications of PIVAS in China, to improve quality control ability for PIVAS management.

RPDRAP is the first PIVAS unified data management platform in China. Using this platform PIVAS can systematically and quickly find its own shortcomings by comparing the management and capacity building of PIVAS in the region.

Now the platform is only used within Yunnan Province. We hope it can be promoted and applied to a wider range of regions. Furthermore, the evaluation matrix of the analysis system should be further expanded and improved based on the progress of research on quality control.