新疆某三甲医院高危药品管理中PDCA循环质量管理工具的使用及效果分析

Application and effect analysis of PDCA cycle quality management tools in high-risk drug management in a top three hospital in Xinjiang

目的探讨策划-实施-检查-改进(PDCA)循环在新疆某三甲医院高危药品管理中的应用效果。方法选取本院2017年1月-2018年1月30个病区,随机分为两组,每组各15个病区,分别采用常规管理(对照组)及PDCA循环对高危药物进行管理(PDCA组)。采用问卷调查方式比较两种管理方式实施后高危药品安全管理评分、使用不合理比例和使用效率的比较。结果 (1)与对照组相比,实施PDCA循环管理的病区中高危药品的药品目录、定期查对、专人管理、专册登记、专人管理、专用标识、标准化流程、专区存放和有效期管理各项评分均显著提高,差异有统计学意义(P <0.05)。(2)与对照组相比,实施PDCA循环管理的病区中高危药品使用的剂量不合理、浓度不合理、频率不合理、发放不合理和输出不合理比率均显著降低,差异有统计学意义(P <0.05或P <0.01)。(3)对照组相比,实施PDCA循环管理的病区中高危药品使用的药品显效显著提高,不合格报废率、复审错误率和不良反应发生率明显下降,差异有统计学意义(P <0.05或P <0.01)。结论在高危药品管理中应用PDCA循环管理模式可有效提高药品的安全管理质量,降低药品使用不合理率,同时增加使用效率。

Objective To explore the application effect of planning-implementation-inspection-improvement(PDCA) cycle in high-risk drug management in a top three hospital in Xinjiang. Methods A total of 30 wards from January 2017 to January 2018 were randomly divided into two groups, each with 15 wards. The management of high-risk drugs was carried out by routine management(control group) and PDCA cycle(PDCA group). Questionnaire survey was used to compare the safety management scores, unreasonable proportions and use efficiency of high-risk drugs after the implementation of the two management methods. Results(1)Compared with the control group, the number of high-risk drugs in the ward of PDCA cycle management, regular checkup rate, special person management,rate special book registration rate, special person management rate, special identification rate, standardization process rate, special area storage and effective period management rate were significantly increased, and the difference was statistically significant(P < 0.05).(2)Compared with the control group, through he implementation of PDCA cycle management, unreasonable doses of high-risk drugs, the unreasonable concentration, the unreasonable frequency of drug use, unreasonable distribution and the unreasonable output ratio were significantly reduced. The difference was statistically significant.(P < 0.05 or P < 0.01).(3)Compared with the control group, the effect of high-risk drugs in the ward of PDCA cycle management were significantly improved, and the unqualified scrap rate, review error rate and adverse reaction rate decreased significantly, and the difference was statistically significant(P < 0.05 or P < 0.01). Conclusion The application of PDCA cycle management mode in high-risk drug management can effectively improve the quality of drug safety management, reduce the unreasonable rate of drug use, and increase the efficiency of use.