PDCA循环模式用于药剂科药品管理效果评价

Effect of PDCA Cycle Model on Drug Administration in the Department of Pharmacy

目的探讨PDCA循环管理模式用于药剂科药品管理的应用价值。方法根据药剂科采用PDCA循环管理模式时间的不同,选取医院2013年1月至2014年4月执行PDCA循环管理模式前的药品121 362件、病例500例及分析医嘱26 234项作为对照组,选取2014年5月至2016年2月采取PDCA循环管理模式的药品98 734件、病例500例及分析医嘱21 358项作为研究组。结果研究组药品使用准确率为99.91%,显效率为99.29%,显著高于对照组的92.94%和94.29%(χ~2=23.58,18.21,P=0.00,0.00);药品的不合格报废率为0.34%,复审错误率为0.75%,明显低于对照组的1.60%和3.14%(χ~2=16.23,13.42,P=0.00,0.00);研究组用药剂量不合理率为0.05%,用药频率不合理率为0.44%,注射剂浓度不合理率为0.03%,超适应证用药率为0.05%,明显低于对照组的0.46%,0.16%,0.46%,0.24%(P<0.05);研究组医嘱高危药品管理总评分明显高于对照组(P<0.05)。结论 PDCA循环管理模式可明显改善药剂科药品管理质量,提高患者用药安全性和药剂科相关人员的综合能力,并可提高临床医师工作效率,值得临床推广。

Objective To investigate the application value of PDCA cycle model in drug administration in the Department of Pharmacy.Methods According to the time of using PDCA cycle management mode,totally 121 362 drugs,500 cases and 26 234 items of analysis of doctors＇ advice before the implementation of PDCA cycle management mode（ from January 2013 to April 2014） in the Department of Pharmacy were selected as the control group,totally 98 734 drugs,500 cases and 21 358 items of analysis of doctors＇ advice during the period of the implementation of PDCA cycle management mode（ from May 2014 to February 2016） in the Department of Pharmacy were selected as the study group. Results The accuracy rate of drug use and the effective rate in the study group were 99. 91% and99. 29%,which were significantly higher than 92. 94% and 94. 29% in the control group（ χ~2 = 23. 58,18. 21,P = 0. 00,0. 00）. The unqualified scrap rate of the drug and the error rate of review were 0. 34% and 0. 75%,which were significantly lower than 1. 60%and 3. 14% in the control group（ χ~2 = 16. 23,13. 42,P = 0. 00,0. 00）. The irrational rates of drug dose,frequency of drug use,injection concentration and the rate of off-label drug use in the study group were 0. 05%,0. 44%,0. 03%,0. 05%,respectively,which were significantly lower than 0. 46%,0. 16%,0. 46%,0. 24% in the control group（ P 0. 05）. The total score of high risk drug management in the study group was significantly higher than that in the control group（ P 0. 05）. Conclusion PDCA cycle management model can significantly improve the quality of pharmaceutical drug management,improve the safety of patients＇ medication,strengthen the comprehensive ability of the related personnel in the Department of Pharmacy,and improve the working efficiency of clinicians,it is worthy of clinical promotion.