品管圈用于提高门诊西药房药品质量管理实践

Application of Quality Control Circle for Improving Drug Quality Management in Outpatient Western Medicine Pharmacy of Our Hospital

目的提高门诊西药房药品质量管理水平。方法根据门诊患者满意度调查表,收集患者意见,其中81.2%的不满因药品管理不善导致。采用头脑风暴法分析导致药品质量的原因,为药品潮解、药品失效、冷藏药品没按贮藏条件冷藏。按照品管圈的十大步骤实施各项活动,拟订活动计划、拟订对策及实施,评价有形成果(药品质量管理提高)和无形成果(圈能力),制订标准化工作流程。结果药品潮解主要是因协定处方及拆零片剂所致;药品失效主要是因药师工作责任心不强,积压药品所致;冷藏药品未冷藏保管主要因冷藏药品品种多、数量大、冰柜少所致。针对以上原因,采取协定处方标准化分装,请领药品规范化,冷藏药品采取少量多批领取并增加冷柜的方法,对药师增强工作责任心等系列措施。活动后潮解药品由活动前的13次下降到5次,失效药品由活动前的5次下降到2次,冷藏管理药品由活动前的16次下降到6次;同时圈员们的工作积极性、团队凝聚力、解决问题的能力等方面均有大幅提高。结论品管圈管理模式的应用,可提高医院门诊西药房的药品质量管理水平。

Objective To improve the drug quality management of outpatient western medicine pharmacy. Methods The opinions of patients were collected according to the outpatient satisfaction questionnaire, in which 81.2% was caused by the drugs mismanagement. The brainstorming method was adopted to analyze the causes leading to the drug quality problems, including the drug deliquescence, drug invalidation and cold storage of refrigerated drugs without according to storage conditions. The various activities were implemented according to 10 steps of quality control circle（QCC）, the plan, countermeasures and implementation of activities were protocolled, the tangible results （improvement of drug quality management） and intangible results（circle ability） were evaluated and the standardized work flow was formulated. Results The drug deliquescence was mainly due to the cipher prescriptions and scattered tablets; drug invalidation was mainly due to the poor working responsibility of pharmacists and the backlog of drugs; refrigerated drugs mainly due to many varieties of cold medicines, large quantity and few refrigerating cabinets. In view of the above reasons, a series of measures were adopted including the standardized packing of cipher prescriptions, standardization of applying receiving drugs, the refrigerated drugs taking the method of small amount and multiple batches of receiving and increasing the refrigerating cabinets, and enhancing the responsibility sense of pharmacists. Alter the activity, the deliquescence drugs were dropped from 13 times before the activity to 5 times, the drug invalidation was dropped from 5 times before the activity to twice, the drugs of cold storage management were dropped from 16 times before the activity to 6 times; at the same time the circle staffs were greatly improved in the aspects of the work enthusiasm, team cohesion and ability to solve problems. Conclusion The application of QCC management model is feasible to improve the quality management of the outpatient Western medicine pharmacy in our hospital.