静脉输液系统化管理模式的构建及实践效果

Construction and practical effect of systematic management mode of intravenous infusion

目的 加强静脉输液系统化管理,规范静脉输液用药行为,促进合理用药。方法 从组织构建、信息化建设、全程精细化管理、质量评价及改进4个部分建立输液管理模式。通过整合部门、知识、数据资源,建设信息系统,组织医护培训及患者宣教,建立泌尿外科试点积极开展输液管理工作。结果 构建形成多部门联动的静脉输液系统化管理模式,多数部门对安全合理输液重视度明显加强。泌尿外科试点工作效果显著。2021年6-12月份数据显示,较6月份,12月份泌尿外科住院患者抗菌药物使用强度下降87.0%,住院患者抗菌药物静脉输液使用率下降18.7%,住院患者静脉输液天数占比下降21.2%,住院患者平均每床日使用体积下降27.3%,住院患者平均每床日使用袋数下降17.4%。指标数据的下降证明了管理模式的有效性。另外,临床医师按照路径合理开具抗菌药物,抗菌药物使用更加规范化。结论 依照系统化管理模式,以信息系统为依托,关注重点监控药品,从试点科室入手有利于逐步加强静脉输液管理,提高用药合理性。

AIM To strengthen systematic management of intravenous infusion,standardize the medication behavior and promote rational medication.METHODS The infusion management mode was established from four parts:organization construction,information construction,implementation of delicacy management throughout the process,quality evaluation and improvement.Infusion management was actively carried out by integrating departments,knowledge and data resources,constructing information system,organizing medical training and patient education,and establishing pilot department of urology.RESULTS A multi-department linkage systematic management mode of intravenous infusion was formed,and most departments attached great importance to safe and reasonable infusion.The pilot work of department of urology achieved remarkable results.The data from June to December 2021 showed that,compared with June,antimicrobial use density of inpatients in December decreased by 87.0%,utilization rate of antimicrobial intravenous infusion of inpatients decreased by 18.7%,proportion of days of intravenous infusion of inpatients decreased by 21.2%,average use volume per bed daily of inpatients decreased by 27.3%,and average number of used bags per bed daily of inpatients decreased by 17.4%.The decline in indicator data proved the effectiveness of the management mode.Besides,doctors prescribed antimicrobials reasonably following the pathways,so the use of antimicrobials was more standardized.CONCLUSION Following the systematic management mode,relying on the information system,paying attention to the key supervised drugs,starting from the pilot departments are beneficial to gradually strengthen the management of intravenous infusion and improve the rationality of medication.