Abstract: Objective To investigate the effect of optimized prevention and control measures based on a double-check workflow on intravenous drug admixture. Methods Data were collected from the pharmacy intravenous admixture service (PIVAS) of the General Hospital of Eastern Theater Command of the Chinese People's Liberation Army from December 2022 to November 2024. Ten nursing units across the hospital were randomly divided into a control group and an intervention group, with five nursing units in each group. Each nursing unit consisted of 12 staff members, totaling 60 staff members, and each group prepared 1 000 000 units of finished intravenous infusions. The control group adopted the conventional intravenous drug admixture process, while the intervention group adopted a double-check workflow. The incidence of intravenous admixture errors, staff professional competence, non-technical skill, and the incidence of adverse events were evaluated in both groups. Results The incidence of intravenous drug admixture errors in the intervention group was 0.016 1%, which was significantly lower than that in the control group (0.022 6%, P < 0.05). The intervention group scored significantly higher than the control group in drug management, drug admixture, environmental control, and total score (P < 0.05). The intervention group also scored significantly higher than the control group in non-technical skills, including sense of responsibility, proactivity, self-confidence, problem-solving ability, and communication and collaboration (P < 0.05). Furthermore, the detection rate of irrational medical orders was significantly higher in the intervention group than in the control group, while the rates of medication dispensing errors, admixture errors, and rechecking and packaging errors were significantly lower in the intervention group (P < 0.05). Conclusion The optimized prevention and control measures based on a double-check workflow in intravenous drug admixture can reduce the incidence of admixture errors, improve staff professional competence and non-technical skills, and decrease the occurrence of adverse events.