PDCA循環(huán)管理在某院門(mén)診處方干預(yù)中的應(yīng)用
發(fā)布時(shí)間:2018-02-13 02:57
本文關(guān)鍵詞: PDCA循環(huán)管理 處方干預(yù) 合理用藥 門(mén)診處方 出處:《中國(guó)藥房》2017年08期 論文類型:期刊論文
【摘要】:目的:評(píng)價(jià)PDCA循環(huán)管理在門(mén)診處方干預(yù)中的應(yīng)用效果。方法:選取某院2014年1-12月門(mén)診處方895 360張(干預(yù)前組)和2015年1-12月門(mén)診處方918 659張(干預(yù)后組),對(duì)實(shí)施PDCA循環(huán)管理前后的門(mén)診不合理處方進(jìn)行分析,并比較用法用量不適宜、臨床診斷書(shū)寫(xiě)不全、醫(yī)師處方未簽名(章)或與留樣不一致等核心指標(biāo)改善情況。結(jié)果:干預(yù)前,不合理處方共2 347張,包括不規(guī)范處方1 401張、不適宜處方849張和超常處方97張。干預(yù)后,不合理處方共1 161張,包括不規(guī)范處方695張、不適宜處方425張和超常處方41張,分別較干預(yù)前組下降了50.53%、50.39%、49.94%和57.73%;用法用量不適宜、臨床診斷書(shū)寫(xiě)不全、醫(yī)師處方未簽名(章)或與留樣不一致、處方用紙不規(guī)范、適應(yīng)證不適宜、處方修改未簽名并注明修改日期或藥品超劑量使用未注明原因和再次簽名、無(wú)特殊情況門(mén)診處方超7 d常用量或急診處方超3 d常用量等占門(mén)診處方總量的比例分別由干預(yù)前的0.72‰、0.57‰、0.45‰、0.27‰、0.20‰、0.19‰和0.15‰降至0.32‰、0.25‰、0.19‰、0.11‰、0.09‰、0.08‰和0.07‰。結(jié)論:PDCA循環(huán)管理用于門(mén)診處方質(zhì)量改進(jìn)效果顯著。該院門(mén)診處方仍存在不合理現(xiàn)象,有待持續(xù)干預(yù)。
[Abstract]:Objective: to evaluate the effect of PDCA circulation management on outpatient prescription intervention. Methods: select 895,360 out-patient prescriptions from 2014 to December in a hospital (pre-intervention group) and 918,659 out-patient prescriptions from January to December on 2015 (post-intervention group), and to implement PDCA. The irrational prescriptions before and after circulation management were analyzed. Results: before intervention, there were 2 347 unreasonable prescriptions, including 1 401 irregular prescriptions. After intervention, there were 1 161 unreasonable prescriptions, including 695 non-standard prescriptions and 41 unsuitable prescriptions, which were 50.53%, 59.94% and 57.73% lower than those before intervention, respectively. The clinical diagnosis is incomplete, the doctor's prescription is not signed (chapter) or inconsistent with the retained sample, the prescription paper is not standardized, the indication is not suitable, the prescription modification is not signed and the date of modification or the drug overdose is used without indicating the reason and the re-signature, The proportion of outpatient prescriptions over 7 days or emergency prescriptions more than 3 days in total outpatient prescriptions decreased from 0.72 鈥,
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