All over the world have called off outpatient infusion, the first infusion safety expert consensus will be released.
Reasonable infusion can save the lives of patients, and an error may also make a life away, infusion safety issues have been deeply concerned. In recent times, all parts of the country have called off outpatient infusion. The Jiangsu Provincial Health and Family Planning Commission even requires that by the end of 2016, hospitals above the second level in Jiangsu Province (except children's hospitals) will completely stop intravenous infusion for outpatients. At the same time, it is urgent to improve the safety of clinical infusion while stopping outpatient infusion in various places. Recently, the China Health Promotion Foundation, China Nursing Association, China Pharmaceutical Packaging Association, China Pharmacists Association and other six organizations jointly compiled the first "Guarding the Safety of Needle Tip-China Infusion Safety and Prevention Expert Consensus" (hereinafter referred to as "Expert Consensus") finalized in Beijing. It is reported that the consensus will be released in May.
Excessive infusion and infusion safety need to be focused on
"Can be taken orally without intramuscular injection, can be intramuscular injection without infusion", which is the principle of medication put forward by who for a long time. Generally speaking, infusion is the "last mode of administration" only for emergency patients, critically ill patients and patients who cannot eat ". However, in our country, for a long time, infusion therapy has been widely abused because it can increase the income of hospitals and doctors, coupled with the psychological factors of many patients seeking "quick and good" treatment.
In recent years, with the in-depth advancement of a series of national "anti-resistance" policies, after the cancellation of outpatient infusions in large hospitals, as the "hardest-hit area" of excessive infusions, the outpatient infusions of local primary medical institutions will gradually be "strictly controlled".
Professor Zhao Zhigang, the main advocate of the "Expert Consensus" and the Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, said that at present, many patients still have some misunderstandings about infusion therapy, such as common fever, diarrhea, gastroenteritis and other common diseases. Insufficient understanding of the risks and adverse reactions of infusion has become one of the important reasons for excessive infusion. The above misunderstandings highlight the need for attention to excessive infusion and infusion safety in my country.
According to the 2014 National Adverse Drug Reaction Monitoring Annual Report, adverse drug reactions (ADR) by intravenous administration accounted for 57.8 percent of the total number of adverse drug reactions. The common adverse reactions of intravenous infusion include allergic reaction, anaphylactoid reaction, pyrogen reaction, local irritation, hemolytic reaction, water and electrolyte disturbance, volume load and so on. Adverse reactions can occur at the beginning of the infusion, or at any time during the infusion process, and some delayed reactions can occur for a period of time after the end of the infusion. The main hazard of insoluble particles is the superposition and accumulation of particles in specific parts, causing tissue damage, organ pathological changes and even death. Professor Zhao Zhigang said that for patients with long-term infusion or a large amount of infusion, the particulate pollution in the infusion process will greatly increase. The more varieties of injections and the longer the course of injection, the endotoxin and particles will be multiplied, and the probability of adverse reactions will increase exponentially. What is more important to note is that the occurrence of adverse events such as microvascular thrombosis, hemorrhage, pulmonary embolism, and granuloma caused by a large number of particles is slow and long-term, which has potential and lasting harm to the human body.
Six organizations jointly push "expert consensus" to help improve clinical infusion safety
It is reported that the preliminary final "expert consensus" is divided into six parts, including the current situation of infusion use in China, the quality and safety evaluation of infusion, the quality and safety evaluation of infusion packaging materials, the quality and safety evaluation of infusion in various countries, the harm of unreasonable use of infusion and the policy recommendations for rational use of infusion. "Consensus" comprehensively combs the current situation and main problems of infusion use in China, introduces the evaluation methods of infusion quality and safety problems from a professional point of view, introduces the guidelines for the rational use of infusion abroad, and puts forward the strategies and methods of comprehensive treatment to solve the problem of excessive infusion in China.
In addition, the first draft of the "Expert Consensus" also gave a more detailed introduction to the current use of medical packaging materials and equipment for infusion. Gu Weijun, president of the China Medical Equipment Engineering Association, said that to improve infusion safety, attention should be paid to process management. For many new processes, new technologies, and new products that have emerged in the field of pharmaceutical production in recent years, recommend suggestions should be given, and backward processes should also be recommended. Cancellation, only the positive interaction between the clinic and the industry can truly improve infusion safety.
As China's first application to large infusion products in the BFS new technology, this has also been written into the "expert consensus." It is understood that this is the infusion BFS technology that China Resources Shuanghe took the lead in introducing from abroad in recent years. Its biggest highlight is the integration of "blowing and potting". Its insoluble particles can be controlled below 5 microns, which is much higher than the national pharmacopoeia standard, thus improving product quality and use safety. Safe infusion products require scientific process design, advanced facilities and equipment, and strict process management. The risk of drugs that directly enter the blood vessels of the human body is much higher than that of drugs taken orally and externally, and high quality also need cost guarantee. "The price of a bottle of infusion is not as good as that of a bottle of mineral water, which will eventually endanger the safety of people's medication." Professor Zhao Zhigang said. Ni Jun, vice president of China Resources Shuanghe, said that to reduce or eliminate unnecessary infusions, to ensure the reliable quality of infusion products supplied by the market, and to minimize safety risks, government departments, medical institutions, manufacturers and the general public need to form a reasonable and safe use of infusion. Consensus, jointly promote.