|
|
Exploring the PDCA cycle management method to improve rational drug use based on the joint application of PASS prescription review and prescribing audit |
ZHANG Xiaoru1 CHANG Hu2▲ WANG Yanting2 GUO Chunlei1 HE Jing1 WANG Ran1 JIN Songtao1 LIU Wei1 ZHANG Yuanqing1 |
1.Guangwai Hospital, Xicheng District, Beijing 100055, China;
2.National Cancer Center National Clinical Research Center for Cancer Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
|
|
|
Abstract Objective To use the application of the PASS prescription review and prescribing audit system as an entry point, multidisciplinary collaboration for continuous improvement, and in order to improve the level of rational drug use. Methods The problems of rational medication management in Guangwai Hospital, Xicheng District, Beijing were summarized through multidisciplinary team interviews, and the PDCA cycle management method was used to improve antibiotics, non-antibiotic western medicine, and proprietary Chinese medicine for the problems and the top three unreasonable medical prescriptions; the improvement effect was evaluated by the monitoring indexes of the hospital’s emergency and outpatient prescriptions in the prescription review system and prescription review system in 2021. Results Before and after the implementation of PDCA cycle management in 2021, the prescription review pharmacist intervention rate, the physician prescription revision rate after pharmacist intervention, and the prescription qualification rate of the prescribing review system gradually increased in the 1st to 4th quarters; the percentage of false-positive prescriptions in the prescription review system gradually decreased; the percentage of problematic prescriptions and the physician revision rate increased in the 2nd quarter compared with the 1st quarter of the prescribing review system, and then gradually decreased in the 3rd to 4th quarters compared with the 1st quarter. Conclusion The application of PDCA cycle management method can effectively improve the level of rational drug use in this hospital.
|
|
|
|
|
[1] 张青霞,王雅崴,李晓玲,等.全国临床安全用药监测网临床安全用药年度报告(2021)[J].药物不良反应杂志,2022,24(5):225-232.
[2] 王素梅,王晶,谢宁,等.处方前置审核系统对我院门诊处方质量的影响[J].上海医药,2020,41(13):53-56.
[3] 唐雄,李昕,徐传新.基于药学知识库的医院合理用药前置审方管理系统的开发与应用[J].中国医学装备,2021, 18(5):129-132.
[4] Zhong YT,Yan SY,Chu YQ.Literature analysis for clinical application and existing problems [J]. China Pharmacy,2020, 31(7):879-883.
[5] Niao LN,Li X,Huang F. Role of the pre-prescription review system in ensuring the safety of drug use inpatients [J]. China Hosp Manag,2018,38(10):23-25.
[6] 国家卫生健康委员会.关于加强药事管理转变药学服务模式的通知[EB/OL].(2017-07-05)[2017-07-12].http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=b44339ebef924f038003e1b7dca492f2.
[7] 国家卫生健康委员会.关于印发医疗机构处方审核规范的通知[EB/OL].(2018-06-29)[2018-07-10].http://www. nhc.gov.cn/yzygj/s7659/201807/de5c7c9116b547af819f825b 53741173.shtml.
[8] 武明芬,史卫忠,赵志刚.国内常用合理用药软件的综合评价[J].中国医院药学杂志,2019,39(10):991-995.
[9] Zuo J,Li X,Niao LN,et al. Analysis of implementation effect of the prescription review system in our hospital [J]. Chin J Hosp Pharm,2019,39(22):2338-2341.
[10] Wang YF,He KB,Bai J,et al. Establishment of pharmaceutical care mode of PIVAS prescription review based on pharmacist and software [J]. Herald Med,2019,38(3):403- 406.
[11] Ji ZS,Song WW,Ai C. Practice and discussion of prescription review [J]. Chin J Hosp Pharm,2018,3(16):1743- 1746.
[12] 刘金玉,曾露,郭敏,等.多学科合作与循证助力处方前置审核模式构建[J].中国医院药学杂志,2021,5(41):948-952.
[13] 张清华,金锐,王琨,等.基于循证药学的处方前置审核系统在门诊药房中的实践与探讨[J].中国医院药学杂志,2020,2(40):443-447.
[14] 廖丽娜,李鑫,左静,等.我院在推进处方前置审核系统运行中存在的问题与对策[J].中国药房,2019,30(5):587-591.
[15] 孙坤,艾超.医院门诊前置处方审核分析及改进[J].中国药业,2017,26(22):92-95.
[16] 甄健存,边宝生,孔繁翠,等.区域性处方点评对临床合理用药的效果评估[J].中华医院管理杂志,2015,31(7):531-533.
[17] 卞婧,魏丽艳,邵晓楠,等.国内医院处方审核与点评开展情况及分析[J].中国医院,2020,2(24):8-11.
[18] 林平,陈宁,梁健华,等.某院培训门诊住院药师处方审核技能的实践[J].中南药学,2017,15(8):1174-1178.
[19] 李鑫,廖丽娜,陈燕红,等.处方前置审核系统在门诊处方审核中的应用[J].实用药物与临床,2018,21(4):475- 479.
[20] 王敏华,王莉.门诊超说明书用药情况分析及管理对策[J].中国现代应用药学,2015,32(5):634-638.
[21] 李鑫,廖丽娜,左静.自主维护知识库在门诊处方前置审核中的应用[J].中国医院管理,2019,39(1):62-64.
[22] 李一帆,封国生,陈慧,等.医药分开改革对门诊处方用药的影响分析[J].中国医院管理,2016,6(2):7-9.
[23] 张书宁,刘渝册,胡金梅.临床常见中西药联用药性辨析[J].中国煤炭工业医学杂志,2003,6(8):760.
[24] 张占杰,李建涛,范洪伟,等.门急诊抗菌药物处方月点评5年的效果评价[J].中华医院管理杂志,2018,34(10):821-825.
[25] 陈婉莹,徐刚,章浩然,等.基于PDCA循环的临床合理用药质控模式构建与应用[J].现代医院,2021,21(11):1709-1711.
[26] 元伟靖,陈复兴,戴左琴.基于Hadoop平台下医保智能分析系统的研究[J].中国当代医药,2022,29(36):145- 147.
[27] 张丽娟,李庆德,郑锦坤,等.出院带药闭环管理系统的开发与应用[J].中国医药科学,2021,11(12):234-236.
[28] 干小红,周后凤,郭远新,等.加强药事监管促进合理用药时间探索[J].中华医院管理杂志,2019,35(z1):52-54. |
|
|
|