我院门诊药房退药原因的帕累托图分析

Pareto Diagram Analysis of Drug Return Reasons in Out-patient Pharmacy of Our Hospital

目的:了解我院退药原因的主要、次要因素,提出相关改进措施,以保证用药安全。方法:抽取我院门诊药房2010年1-10月退药药品425种,经Excel软件进行退药数据处理,利用帕累托图法,按分类项目统计频数,计算累计频率,制作退药原因统计分类表并绘制帕累托图,同时分析退药原因的主要、次要、一般因素。结果:退药原因位居前3项的药品不良事件(40.47%)、诊断改变(24.24%)和不合理用药(12.94%)为主要因素,入院或院外治疗(8.24%)为次要因素,重复用药(6.12%)、收费问题(2.82%)等为一般因素。结论:应采取加强制度建设与处方点评、提高医师的诊治水平和服务意识、加强医院硬件建设与药师素质等措施,把影响退药的主要、次要因素限制在可控范围内。

OBJECTIVE： To investigate the primary and secondary reasons of drug return in our hospital and to put forward relevant countermeasures to guarantee the safety of drug use.METHODS： 425 kinds of returned drugs in out-patient pharmacy of our hospital from Jan.to Oct.in 2010 were collected and processed using Excel software.The Pareto diagram analysis was used to make drug return reasons classification tablets and Pareto diagram according to statistical frequency of each item and accumulative frequency.The primary,secondary reasons and common influencing factors of drug return were analyzed.RESULTS： Three primary reasons leading to drug return were adverse drug events（40.47%）,diagnosis change （24.24%） and irrational drug use （12.94%）.The secondary reasons involved intramural or extramural hospital treatment （8.24%）.Common influencing factors were reduplicate drug use （6.12%） and charge problem （2.82%）,etc.CONCLUSION： A series of measures should be adopted including strengthening system construction and prescription evaluation,improving doctor’s diagnosis ability and service consciousness,enhancing hardware construction and pharmacist’s professional competence so as to control primary and secondary factors in controllable scope.