PDCA循环管理在规范雾化吸入药物临床使用中的作用

The Role of PDCA Cycle Management in Standardizing Clinical Application of Atomization Inhalation Drugs

目的:评价PDCA循环管理在规范雾化吸入药物临床使用中的作用。方法:采用回顾性分析方法,抽取我院2013年1-12月雾化吸入用药病历300份(非干预组)、2014年4-6月200份(1次循环干预组)、2014年10-12月180份(2次循环干预组),比较实施PDCA循环管理前后雾化吸入药物的使用情况;并分别于2次干预前后调查医、药、护、技等4类医务人员对雾化吸入药物相关知识的知晓情况。结果:经过2次PDCA循环管理干预,我院抗菌药物、长效糖皮质激素、非雾化吸入剂型化痰药物、蛋白分解酶类药物等给药途径不适宜的比例分别由干预前的54.0%、62.0%、59.7%、44.7%降至0.6%、1.1%、15.0%、1.1%,且无雾化频次不适宜、适应证不适宜、预防与控制症状药物混用、中药注射剂及非雾化剂型茶碱类药物雾化吸入等现象。医护人员熟悉雾化吸入用装置、药物分类、预防和治疗药物的选择、医院常备药物种类的比例由干预前的38.0%、79.0%、49.0%、39.5%提高至93.4%、86.7%、92.4%、96.2%。结论:临床药师应用PDCA循环管理,有效规范了我院雾化吸入药物的临床使用;该方法可在其他医疗管理领域推广使用。

OBJECTIVE：To evaluate the role of PDCA cycle management on standardizing clinical use of atomization inhalation drug. METHODS：Using a retrospective method,300 medical records of atomization inhalation drug use were collected from our hospital during Jan.-Dec. in 2013（non-intervention group）,200 medical records collected during Apr.-Jun. in 2014（one cycle intervention group）,and 180 medical records collected during Oct.-Dec. in 2014（two rounds of cycle intervention group）. The use of atomization inhalation drugs was compared before and after the application of PDCA cycle management. Before and after two cycle intervention,4 types of medical staff were investigated on cognition of the related knowledge of atomization inhalation drugs,as physicians,pharmacists,nurses and mechanic. RESULTS：After two rounds of PDCA cycle management and intervention,the proportion of unsuitable route of administration of antibiotics,long acting glucocorticoid,non- atomization inhalation dosage form of resolving phlegm drugs,protease decreased from 54.0%,62.0%,59.7%,44.7% before intervention to 0.6%,1.1%,15.0%,1.1% after intervention;those phenomena had not been found,such as unsuitable route of administration of TCM injection and nonatomization dosage form of theophyllines,unsuitable atomization frequence,unsuitable indication,drug mixture for preventing and controlling symptom,etc. The proportion of medical staffs being familiar with medical device,drug classification,drug selection for prerention and treatment and the proportion of hospital drug stock to 93.4%,86.7%,92.4%,96.2% after intervention from38.0%,79.0%,49.0%,39.5% before intervention. CONCLUSIONS：The application of PDCA cycle management can effectively regulate the use of atomization inhalation drugs in our hospital;the method can be promoted and applied.