麻醉、精神药品三级管理制度

problems that cannot be ignored. Some leaders unwilling to do masses work, masses concept weak, on masses feelings not deep, pendulum not are with masses of relationship, think masses work is revolutionary war era of things, now obsolete has, buried business work, ignored masses work of situation compared General; some leaders not do masses work, old method regardless of with, new not with, not understand masses psychological, not understand masses wishes, not said masses language, work method simple stiff, caused masses of conflict and antipathy; some leaders can't do masses work, Faced with a lot of contradictions among the people worry about fear, panic set in encounter group events, and some are even mismanaged, inflame, so work has suffered heavy losses, and so on. These problems we are soberly aware, enhancing the party's ruling capability, themaintenance and development of the party's advanced nature and purity, and to enhance the ability of party committees and leading cadres are good people. Attach great importance to and is good at doing mass work, has become the new urgent situation strengthening the party's governing capacity-building tasks. Combined practice of maintaining flesh-and-blood ties with the masses, urged the broad masses of party members and cadres, especially all levels ... Processing to improve as a guide to the country. \d is summed up these new things, be promoted. \s a vivid manifestation of the Deng Xiaoping's mass. Deng also put people \ppy\se not to promise\point and destination of developing guidelines, policies, and as the only standard for measuring compliance with the wishes of the masses of the people. Under the guidance of Deng Xiaoping theory, Central Government adopted a series of important measures to strengthen links with the masses. In December 1989, the CPC Central Committee made on adhering to and perfecting the system of multi-party cooperation and political consultation under the leadership of the Chinese Communist Party, closely for CPC and the democratic parties and the relationship between the part of the masses that they contact, effectively carrying out the mass line, played a positive role. In March 1990, the 13 plenary session adopted the decision on strengthening contacts with the masses of the Party noted that \and developed in the long struggle of the party's mass ine, is to realize the party's ideological line, the fundamental political and organizational work route\n always maintain flesh-and-blood ties and development of the masses, is directly related to the rise and fall of the rise and fall of the party and State. In September 1994, 14 adopted by the plenary session of the Party on strengthening decision on several major issues of party building. The requirements of the decision of the party's leading bodies and leading cadres should develop a democratic style of work, come from the masses, to the masses, together, stick to the mass line. Party of 13 session four in the plenary yihou, to Jiang comrade for core of party麻醉、精神药品三级管理制度 编制人 审核人： 批准人 制度 文件编号：YJK –JMYP-02 版本：1.0 生效日期： 页码： 3 1目的

规范麻醉药品、精神药品管理，确保各环节安全。 2 范围

适用于麻醉药品、精神药品采购、贮存、领发、使用等各环节的管理。 3 职责

药学部：负责麻醉药品、精神药品日常工作。 4 具体工作

为了规范我院麻醉、精神药品管理，参照《药品管理办法》、《麻醉药品和精神药品管理条例》和《处方管理办法》，特制订我院麻醉一类精神药品分级管理制度。 麻醉一类精神药品分级管理制度是指在我院实行药库、药房、病区三级管理制度： 4.1一级管理即药库管理： 4.1.1 采购员的岗位职责：

4.1.1.1根据《麻醉药品、第一类精神药品购用印鉴卡管理规定》做好印鉴卡的申领工作。

4.1.1.2按有关规定到指定的医药公司采购麻醉药品和精神药品，采购的麻醉药品和第一类精神药品由指定医药公司用专车送到药库，协助保管人员核对品名、规格、数量、有效期等并逐支逐盒检查麻醉药品、第一类精神药品的质量和完整性。 4.1.1.3购买麻醉药品、第一类精神药品付款应当采取银行转帐方式。 4.1.1.4根据本单位医疗需要，按照规定购进麻醉药品、精神药品，保持合理库存。 4.1.1.5在验收中发现麻醉药品、第一类精神药品存在缺少、缺损现象的，应与保管员双人清点登记，报院长批准并加盖公章后向供货单位查询、处理。 4.1.2 药库管理：

4.1.2.1麻醉药品和第一类精神药品采购与保管必须分别由专人负责。

4.1.2.2药库的麻醉药品和第一类精神药品需储存于专用的保险箱内，双人双锁保管，有条件应配备监控设施。

4.1.2.3采购麻醉药品、精神药品时必须进行严格的数量和质量检查，确保数量和质量无误后方可入库及领用。

4.1.2.4严格凭调剂室的领用单出库，出库时认真核对药品名称、规格、数量、有

第 1 页 共 3 页 f third generation Central led collective, banner Deng Xiao-ping's theory great flag, insisted liberation thought, and facts, and times, in both at home and abroad political storm, and economic risk, severe test before, relies on party and people, defended China features Socialist, created socialist market new system, created full open new situation, advance party of construction new of great engineering, founded \esentative\hought, Continue to steer the ship of reform and opening up forward on the right. Comrade Jiang Zemin said: \ng and improving the party's mass work in the new situation, it is of decisive significance to consolidating the ruling Foundation of the party. \nd some of the world's major lessons learned from the success of the old party of the party, Comrade Jiang Zemin pointed out:\biggest political advantage of our party is in close contact with the masses, the most dangerous after the ruling party was divorced from the masses. \d:\orm and construction, only the understanding, support and participation of the people, people's enthusiasm and creativity into full play in order to advance; the leadership of the party, only the tie and win the masses embraced, can be consolidated and strengthened. \nted out that strengthening and improving the party's work style construction, maintaining the party's flesh-and-blood ties with the masses is the core problem, the key is to do solid work, implement, resolutely oppose and overcome formalism. Comrade Jiang Zemin stressed that all the work and policies of the party, are in compliance with the fundamental interests of the overwhelming majority of the people to the highest degree, to the majority of people are not satisfied with the fundamental guidelines, strive to make our workers, farmers, intellectuals and other people enjoy ... Single, everyone seemed to know. But well known does not mean perfect. Some party members and leading cadres, consider contacting their small departments, within a small circle of people, or contact individual owners, the entrepreneur, is the masses, this idea is obviously not correct. The Communist Party of China, people should have three characteristics. First, the people should be the most social, is a Department within the scope of the majority. Specific to the party and Government departments, especially the cadres working in the Central and State organs, mass is the 1.3 billion Chinese people, work for the party members and cadres, masses are the land within the jurisdiction of the common people. The second characteristic of the masses, is that we have common interests. Masses are manifestations of each specific people, but the crowd is a comprehensive political concept, refers to people with common political and economic interests in the period of social transformation, social differentiation between the interests of the masses is large, if you do not find the interest in doing mass work, the party members and cadres, will be in a passive position. The third characteristic of the massesproblems that cannot be ignored. Some leaders unwilling to do masses work, masses concept weak, on masses feelings not deep, pendulum not are with masses of relationship, think masses work is revolutionary war era of things, now obsolete has, buried business work, ignored masses work of situation compared General; some leaders not do masses work, old method regardless of with, new not with, not understand masses psychological, not understand masses wishes, not said masses language, work method simple stiff, caused masses of conflict and antipathy; some leaders can't do masses work, Faced with a lot of contradictions among the people worry about fear, panic set in encounter group events, and some are even mismanaged, inflame, so work has suffered heavy losses, and so on. These problems we are soberly aware, enhancing the party's ruling capability, the maintenance and development of the party's advanced nature and purity, and to enhance the ability of party committees and leading cadres are good people. Attach great importance to and is good at doing mass work, has become the new urgent situation strengthening the party's governing capacity-building tasks. Combined practice of maintaining flesh-and-blood ties with the masses, urged the broad masses of party members and cadres, especially all levels ... Processing to improve as a guide to the country. \did is summed up these new things, be promoted. \vid manifestation of the Deng Xiaoping's mass. Deng also put people \not support\ppy\promise\starting point and destination of developing guidelines, policies, and as the only standard for measuring compliance with the wishes of the masses of the people. Under the guidance of Deng Xiaoping theory, Central Government adopted a series of important measures to strengthen links with the masses. In December 1989, the CPC Central Committee made on adhering to and perfecting the system of multi-party cooperation and political consultation under the leadership of the Chinese Communist Party, closely for CPC and the democratic parties and the relationship between the part of the masses that they contact, effectively carrying out the mass line, played a positive role. In March 1990, the 13 plenary session adopted the decision on strengthening contacts with the masses of the Party noted that \d and developed in the long struggle of the party's mass line, is to realize the party's ideological line, the fundamental political and organizational work route\n always maintain flesh-and-blood ties and development of the masses, is directly related to the rise and fall of the rise and fall of the party and State. In September 1994, 14 adopted by the plenary session of the Party on strengthening decision on several major issues of party building. The requirements of the decision of the party's leading bodies and leading cadres should develop a democratic style of work, come from the masses, to the masses, together, stick to the mass line. Party of 13 session four in the plenary yihou, to Jiang comrade for core of party效期等，及时做好药品的出库帐登记。认真填写“麻醉药品、第一类精神药品入库验收记录专簿及进出库专用帐册”。

4.1.2.5麻醉药品、精神药品管理人员必须定期检查麻醉药品、精神药品的质量和有效期，发现药品出现质量问题，立即向科主任汇报，经科主任同意后，严格按规定填写“麻醉药品、精神药品销毁记录表”，报请科主任和主管院长签字同意，向所在地卫生局申请，并在所在地卫生局工作人员的监督下销毁处理。 4.1.2.6药库对麻醉、一类精神药品要做到“五专”，即 专人负责，专柜加锁，专用帐册、专用处方、专册登记。

4.1.2.7药库保管员组织、实施对麻醉药品、第一类精神药品空安瓿及废贴的销毁并详细登记“麻醉药品、第一类精神药品空安瓿及废贴销毁记录表”。 4.2二级管理即药房管理：

4.2.1药房应配备专人负责麻醉药品和第一类精神药品调配管理。 4.2.2药房向药库领用麻醉药品和第一类精神药品时，应按需要填写领单，不得大批量领用。科室内部门之间调拨须经科主任批准。 4.2.3麻醉药品和第一类精神药品，应定期由专人负责清点统计工作，确保正确无误，认真做好“药房麻醉药品、第一类精神药品逐日消耗专用帐册”及“麻醉药品、第一类精神药品处方登记专册登记本”的登记工作。

4.2.4药剂人员调配处方时首先应核查处方是否为麻醉药品、精神药品专用处方，处方各项内容是否完整，处方医生是否有麻醉药品、精神药品处方权，处方用量是否符合要求。

4.2.5调配麻醉药品和精神药品，调配人员必须认真核对药品名称、规格、数量、有效期，在药袋注明患者姓名、药品名称、用法用量，并在处方上签全名。 4.2.6发药人员必须严格核对病人姓名、药品名称、规格、数量、有效期，认真交待用药方法及注意事项，并在处方上签全名。 4.2.7患者在门诊就诊时配麻醉药品注射剂，药剂人员不发药品实物；交待患者到注射室注射。急诊、门诊注射室护士根据相关依据和空安瓿来门、急诊药房调换，药剂人员按规定进行空安瓿回收、销毁并详细登记。

4.2.8调剂室不得办理麻醉药品和第一类精神药品的退药手续。患者停药后，患者（或患者家属）无偿交回的剩余麻醉药品和第一类精神药品，应办理“患者剩余麻醉药品、第一类精神药品回收凭证”，由医疗机构按照规定销毁处理，并填写“麻醉药品、精神药品销毁记录表”。 4.2.9患者在门、急诊就诊时配第一类精神药品注射剂时，药剂人员应要求患者（或代办人）将该药品原批号的空安瓿交回药房，药剂人员进行回收并详细登记“麻醉药品、第一类精神药品空安瓿及废贴回收记录表”。 4.3三级管理即病区的使用管理：

4.3.1麻醉药品和第一类精神药品的使用管理

f third generation Central led collective, banner Deng Xiao-ping's theory great flag, insisted liberation thought, and facts, and times, in both at home and abroad political storm, and economic risk, severe test before, relies on party and people, defended China features Socialist, created socialist market new system, created full open new situation, advance party of construction new of great engineering, founded \sentative\nt thought, Continue to steer the ship of reform and opening up forward on the right. Comrade Jiang Zemin said: \ngthening and improving the party's mass work in the new situation, it is of decisive significance to consolidating the ruling Foundation of the party. \hrough our party and some of the world's major lessons learned from the success of the old party of the party, Comrade Jiang Zemin pointed out:\political advantage of our party is in close contact with the masses, the most dangerous after the ruling party was divorced from the masses. \id:\construction, only the understanding, support and participation of the people, people's enthusiasm and creativity into full play in order to advance; the leadership of the party, only the tie and win the masses embraced, can be consolidated and strengthened. \nted out that strengthening and improving the party's work style construction, maintaining the party's flesh-and-blood ties with the masses is the core problem, the key is to do solid work, implement, resolutely oppose and overcome formalism. Comrade Jiang Zemin stressed that all the work and policies of the party, are in compliance with the fundamental interests of the overwhelming majority of the people to the highest degree, to the majority of people are not satisfied with the fundamental guidelines, strive to make our workers, farmers, intellectuals and other people enjoy ... Single, everyone seemed to know. But well known does not mean perfect. Some party members and leading cadres, consider contacting their small departments, within a small circle of people, or contact individual owners, the entrepreneur, is the masses, this idea is obviously not correct. The Communist Party of China, people should have three characteristics. First, the people should be the most social, is a Department within the scope of the majority. Specific to the party and Government departments, especially the cadres working in the Central and State organs, mass is the 1.3 billion Chinese people, work for the party members and cadres, masses are the land within the jurisdiction of the common people. The second characteristic of the masses, is that we have common interests. Masses are manifestations of each specific people, but the crowd is a comprehensive political concept, refers to people with common political and economic interests in the period of social transformation, social differentiation between the interests of the masses is large, if you do not find the interest in doing mass work, the party members and cadres, will be in a passive position. The third characteristic of the masses problems that cannot be ignored. Some leaders unwilling to do masses work, masses concept weak, on masses feelings not deep, pendulum not are with masses of relationship, think masses work is revolutionary war era of things, now obsolete has, buried business work, ignored masses work of situation compared General; some leaders not do masses work, old method regardless of with, new not with, not understand masses psychological, not understand masses wishes, not said masses language, work method simple stiff, caused masses of conflict and antipathy; some leaders can't do masses work, Faced with a lot of contradictions among the people worry about fear, panic set in encounter group events, and some are even mismanaged, inflame, so work has suffered heavy losses, and so on. These problems we are soberly aware, enhancing the party's ruling capability, the maintenance and development of the party's advanced nature and purity, and to enhance the ability of party committees and leading cadres are good people. Attach great importance to and is good at doing mass work, has become the new urgent situation strengthening the party's governing capacity-building tasks. Combined practice of maintaining flesh-and-blood ties with the masses, urged the broad masses of party members and cadres, especially all levels ... Processing to improve as a guide to the country. \did is summed up these new things, be promoted. \vid manifestation of the Deng Xiaoping's mass. Deng also put people \support does not support\ppy\promise\starting point and destination of developing guidelines, policies, and as the only standard for measuring compliance with the wishes of the masses of the people. Under the guidance of Deng Xiaoping theory, Central Government adopted a series of important measures to strengthen links with the masses. In December 1989, the CPC Central Committee made on adhering to and perfecting the system of multi-party cooperation and political consultation under the leadership of the Chinese Communist Party, closely for CPC and the democratic parties and the relationship between the part of the masses that they contact, effectively carrying out the mass line, played a positive role. In March 1990, the 13 plenary session adopted the decision on strengthening contacts with the masses of the Party noted that \eated and developed in the long struggle of the party's mass line, is to realize the party's ideological line, the fundamental political and organizational work route\n always maintain flesh-and-blood ties and development of the masses, is directly related to the rise and fall of the rise and fall of the party and State. In September 1994, 14 adopted by the plenary session of the Party on strengthening decision on several major issues of party building. The requirements of the decision of the party's leading bodies and leading cadres should develop a democratic style of work, come from the masses, to the masses, together, stick to the mass line. Party of 13 session four in the plenary yihou, to Jiang comrade for core of party4.3.1.1储存：配备防盗设施，不得与其它药品混放，专柜加锁，钥匙由专人保管。 4.3.1.2专人管理：备用麻醉药品和第一类精神药品注射剂的各病区应在病区主任领导下指定专人负责麻醉药品和第一类精神药品的帐物管理。

4.3.1.3麻醉药品和第一类精神药品的备用：病区应根据医疗实际需要申报备用麻醉药品和一类精神药品注射剂的品种、数量，上报院麻醉药品、精神药品管理机构主管院长批准，到药房办理相关手续备案，由药房发给备用量，作为备用药品，否则不得备用。

4.3.1.4麻醉药品和第一类精神药品的日常领用：有备用针剂的科室凭专用处方和空安瓿领取；无备用药品的科室凭专用处方领药，用后立即交还经登记过的空安瓿和废贴。

4.3.1.5麻醉药品和第一类精神药品残余液、空安瓿、废贴的处理：医疗机构病区调配使用麻醉药品、第一类精神药品注射剂有残余液时，必须有二人在场立即销毁处置；麻醉药品和第一类精神药品使用后的空安瓿和废贴必须交回药房统一销毁处理，并认真填写“麻醉药品、第一类精神药品临床使用、空安瓿回收、残余液销毁登记记录”。

4.3.1.6使用过程中的特殊处理：患者拒绝使用已经剖开的麻醉药品和第一类精神药品针剂，除按残余液处理外，还应在处方及“麻醉药品、第一类精神药品临床使用、空安瓿回收、残余液销毁登记记录”上写明“患者拒绝使用”；患者拒绝使用未剖开的麻醉药品和第一类精神药品针剂或医师开错，应当日内退还药房。 4.3.1.7效期管理：药剂科每季度定期检查，各病区应遵循先进先出、近效期先出的原则，不用请及时退库或调换，严防过期。

4.3．1.8 “麻醉药品、第一类精神药品交接班记录本”和“麻醉药品和一类精神药品临床使用、空安瓿回收、残余液销毁登记记录”保存三年。 4.3.2第二类精神药品的使用管理

4.3.2.1第二类精神药品凭医嘱单每日发一日用量；

4.3.2.2出院带药及特殊情况凭医嘱单和第二类精神药品专用处方领药。 4.4医院建立麻醉、第一类精神药品使用专项检查制度

每月组织相关人员对麻醉药品、第一类精神药品使用进行专项检查，并认真做好检查记录，提出存在的问题和隐患，并及时纠正。

第 3 页 共 3 页 f third generation Central led collective, banner Deng Xiao-ping's theory great flag, insisted liberation thought, and facts, and times, in both at home and abroad political storm, and economic risk, severe test before, relies on party and people, defended China features Socialist, created socialist market new system, created full open new situation, advance party of construction new of great engineering, founded \esentative\hought, Continue to steer the ship of reform and opening up forward on the right. Comrade Jiang Zemin said: \ng and improving the party's mass work in the new situation, it is of decisive significance to consolidating the ruling Foundation of the party. \nd some of the world's major lessons learned from the success of the old party of the party, Comrade Jiang Zemin pointed out:\biggest political advantage of our party is in close contact with the masses, the most dangerous after the ruling party was divorced from the masses. \d:\orm and construction, only the understanding, support and participation of the people, people's nthusiasm and creativity into full play in order to advance; the leadership of the party, only the tie and win the masses embraced, can be consolidated and strengthened. \nted out that strengthening and improving the party's work style construction, maintaining the party's flesh-and-blood ties with the masses is the core problem, the key is to do solid work, implement, resolutely oppose and overcome formalism. Comrade Jiang Zemin stressed that all the work and policies of the party, are in compliance with he fundamental interests of the overwhelming majority of the people to the highest degree, to the majority of people are not satisfied with the fundamental guidelines, strive to make our workers, farmers, intellectuals and other people enjoy ... Single, everyone seemed to know. But well known does not mean perfect. Some party members and leading cadres, consider contacting their small departments, within a small circle of people, or contact individual owners, the entrepreneur, is the masses, this idea is obviously not correct. The Communist Party of China, people should have three characteristics. First, the people should be the most social, is a Department within the scope of the majority. Specific to the party and Government departments, especially the cadres working in the Central and State organs, mass is the 1.3 billion Chinese people, work for the party members and cadres, masses are the land within the jurisdiction of the common people. The second characteristic of the masses, is that we have common interests. Masses are manifestations of each specific people, but the crowd is a comprehensive political concept, refers to people with common political and economic interests in the period of social transformation, social differentiation between the interests of the masses is large, if you do not find the interest in doing mass work, the party members and cadres, will be in a passive position. The third characteristic of the masses

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