The Han Dynasty physician Zhang Zhongjing will be decoction of water into rain, thousands of Yang water and other kinds of; Xu Ling tire that: "decoction method, the most appropriate to speak in depth, the effect of the medicine is not effective, all care about this"; Li Shizhen pointed out the adverse consequences of improper decoction of the liquid medicine: "Where the service of the soup medicine, although the product of specialization, repair treatment, such as the law, and decoctions of the recklessness of the times, the water and fire is bad, out of proportion to the fire, then the medicine is also no work. All these show that the ancients have recognized that the decoction process has many factors affecting the quality of decoction, and the quality of the decoction directly affects the efficacy of Chinese medicine.
At present, the decoction room of medical institutions is responsible for providing patients with the service of decoction and preparation of soup, so it is of great practical significance to standardize its management. The Code for the Administration of Decoction Rooms of Traditional Chinese Medicines in Medical Institutions (hereinafter referred to as "the Code") was released in March 2009, aiming to strengthen the standardization and institutionalization of the decoction rooms of traditional Chinese medicines to ensure the quality of decoction of traditional Chinese medicines and to ensure that the traditional Chinese medicines are safe and effective. With the continuous improvement of decoction equipment, decoction by decocting machine has gradually replaced the traditional mode of manual decoction, and there are no specific operational rules for decoction by decocting machine in the "Code". As the structure and function of the equipment used in each unit are not exactly the same, the specific operation rules are also different, so the quality of the decoction also varies.
Improving the environment for decoction
Most of the decoction laboratories were established before the introduction of 'norms'. Due to economic embarrassment, lack of personnel and other aspects of the reasons, most of the small area, the layout of the phenomenon of irrational, mainly in: the work area and living area can not be separated; the work area of the corresponding storage, preparation, decoction, cleaning and other functional areas can not be separated; cleaning, cleaning and disinfection of the equipment, utensils, without a dedicated place to keep. According to the requirements, the clinical use of medicine compatible decoction room, should be spacious and bright, increased ventilation, temperature regulation, dust removal, water and fire prevention facilities, the work area of the functional division of the various parts of the stainless steel work surface is smooth and clean, the walls and floors are in line with the specification requirements.
Improve the quality of personnel
The quality of the decoction room staff is directly related to the quality of the decoction. Dedicated a Chinese pharmacist is specifically responsible for the work of the decoction room, decoction staff must be trained before taking the job, and only after passing the exam can they take the job. Usually a monthly business study, mainly explain the basic knowledge of Chinese medicine decoction, such as soaking and decoction time, the amount of water, the amount of water added, first decoction after the operation of special decoction method, etc., as well as operational skills training, so that each decocting staff to master the basic knowledge, according to the correct operating procedures for the operation, and the knowledge of the continuous updating, continuous technical progress, and to better provide patients with high quality service.
Improve the management system
The operation of Chinese medicine decoction is very critical, soaking time, fire, decoction time and so on have strict regulations, cleaning, disinfection and so on are directly related to the quality of drugs. Therefore, it is particularly important to establish a sound working system and operating procedures for decoction, cleaning and disinfection, and to improve the quality control measures to ensure the quality of decoction, the specific measures are:
First, the development of decoction, cleaning, disinfection and other operating procedures, as well as the basic workflow of the decoction room. The basic process includes taking medicine from the pharmacy, checking the registration, soaking, decoction, packaging, review, delivery of medicine and dumping dregs, cleaning up the health, etc.
The first is to develop the operating procedures and the basic workflow of the decoction room.
The second is to make a good record of the decoction. The record includes the patient's name, age, gender, age, department bed number, number of doses, soaking people, decoction people, the amount of water, soaking time, decoction time, special decoction method and other content. The decoction record shall be filled in and signed by the operators of each section in time, and the content shall be complete and true, and shall not be altered arbitrarily. The decoction record is convenient for error tracing and responsibility checking, which makes the staff of each link to strengthen the sense of responsibility and be responsible for each patient.
Third, the establishment of the review and verification system. Review and check is the decoction room of each work link to reduce errors, to prevent accidents and important links and the necessary protection. The content of the key check is: the decoction personnel to receive to be decocted tablets and pharmacy receipt records are consistent; labeling is correct; all kinds of records are filled out completely and correctly; after the packaging of the medicine to check the number of doses, check whether the packaging is intact, labeling is correct; after the delivery of the medicine is signed by the person who receives the medicine, and so on.
Fourth, the establishment of the Chinese medicine emergency decoction system. According to the requirements of the Code, medical institutions should be able to provide emergency decoction service. The emergency decoction of medicines is required to be completed within two hours, and records of emergency decoction are made.
Fifth, add *** hygiene management. The decoction room dipping bucket, measuring cup, decoction machine, packaging machine to do before and after the use of timely scrubbing clean, dregs of timely cleaning and dumping, the work table, the ground to keep clean. In accordance with the regulations of the regular decoction equipment and facilities, containers with the prescribed disinfectant disinfection, disinfectant replacement on a regular basis; regular indoor fumigation with lactic acid or air disinfection with ultraviolet lamps.
Strengthening quality control
Strengthen the quality control and monitoring of decoction. The head of the department and the person in charge of the decoction room regularly (at least once a quarter) to assess the quality of the decoction work, inspection, and monthly serious consultation with medical staff and hospitalized patients, so that there is written information available. The inspection process is deep into every aspect of the decoction, the implementation of each decoction staff; the development of medication satisfaction questionnaire, to seek the views of health care workers and hospitalized patients, and timely improvement of the shortcomings of the work.
In recent years, hospital management year work across the country in-depth, hospital management year inspection content as well as hospital level assessment standards are on the Chinese medicine decoction room put forward specific requirements, and the score is relatively heavy, hospitals at all levels in accordance with the "medical institutions, Chinese medicine decoction room management norms," the requirements of the investment in a large amount of money, equipment, personnel, etc. established in line with the standard of the decoction room, and therefore to strengthen the management of the decoction room, gradually make the decoction room management norms, and the decoction room. Therefore, it is particularly important to strengthen the management of decoction room and gradually standardize and institutionalize the management of decoction room. Chinese medicine decoction room staff should continue to strengthen their own business quality improvement, research decoction process, to ensure the quality of decoction, give full play to the advantages of the characteristics of traditional Chinese medicine, so that the Chinese medicine soup in traditional Chinese medicine treatment to play its due role.