PDCA循环促进门诊糖皮质激素的合理应用

PDCA Cycle Promotes Rational Application of Glucocorticoids in Outpatients

目的探讨PDCA循环对门诊糖皮质激素合理应用的影响。方法随机抽取未应用PDCA管理前应用糖皮质激素的处方和应用PDCA循环干预后应用糖皮质激素的处方,对比分析糖皮质激素的应用情况。结果应用PDCA循环干预后,糖皮质激素处方合格率显著增加(干预前为83.7%,干预4组为95%,P<0.01),超适应证应用糖皮质激素的处方比例(干预前为9%,干预4组为4%,P<0.05)和用法不适宜处方比例(干预前为10%,干预4组为3.3%,P<0.01)均显著下降。结论 PDCA循环干预通过降低糖皮质激素的超适应证应用和用法不适宜的情况来增加笔者所在医院糖皮质激素处方合格率,但仍有少数处方仍然存在超适应证应用和用法不适宜的情况。

OBJECTIVE To explore PDCA cycle on the rational application of glucocorticoids in outpatients. METHODS The prescriptions before intervening with PDCA cycle and after that were adopted to analyze the clinical application of glucocorticoids.RESULTS After intervention with PDCA cycle,the ratio of glucocorticoids prescription with rational application of glucocorticoids was significantly elevated（ from 83.7% to 95%,P〈0.01）,however,the ratio of glucocorticoids prescription without indications and the ratio of glucocorticoids prescription with inappropriate usage were both significantly reduced,decreasing from 9% to 4%（ P〈0.05） and from 10% to 3.3%（ P〈0.01）. CONCLUSION PDCA cycle could remarkably increase the ratio of glucocorticoids prescription with rational application of glucocorticoids by reducing the improper application of glucocorticoids,however,there is few prescriptions existing inappropriate usage and no indications.