北京市76家医院恶性肿瘤化疗质控现状调查研究

The status quo and analysis of quality control of cancer chemotherapy in 76 hospitals in Beijing

目的探讨北京市各医院恶性肿瘤化疗质量控制现状及其存在的主要问题，提出改进措施。方法在北京市开展恶性肿瘤化疗的76家二级及以上医院中，对每家医院肿瘤化疗住院病历10份（每月1份）进行质量控制检查。76家医院共检查病历756份。结果医院等级越高，其肿瘤化疗整体规范性和质量控制水平越高，只有36.8％的医院配置了静脉配液中心。肿瘤科在化疗质控和药事质控方面均优于非肿瘤科，差异均有统计学意义（均P〈0．01）。有肿瘤临床专科药师医院的化疗质控和药事质控得分分别为50．6和14．5分，高于无肿瘤临床专科药师的医院（分别为47．2和12．7分），差异均有统计学意义（均P〈0．05）。结论应重点提高二级医院的肿瘤化疗质控水平，加强肿瘤内科专科培训。尝试建立肿瘤内科医师准人制度，加强肿瘤专科临床药师的配备和培训，促进肿瘤规范化化疗。

Objective Investigated the status quo of quality control of cancer chemotherapy in hospitals in Beijing to discover the main problems and provide the improvement measures. Methods One medical record of cancer chemotherapy was taken every month for examination of quality control, and a total of 10 medical records in each hospital were examined. A total of 756 medical records from 76 hospitals were examined. Results The results of analysis showed that the overall standardization and quality control of cancer chemotherapy was positively correlated with the grade of hospital. Only 36.8% of the hospitals were equipped with Pharmacy Intravenous Admixture Services （PIVAS）. In terms of quality control of chemotherapy and medicine, the department of oncology had better performance than other departments （ P〈 0.01 ）. The scores of quality control of chemotherapy and medicine in the hospitals with clinical specialist pharmacists were 50.6 and 14.5, significantly higher than 47.2 and 12.7 of those without clinical specialist pharmacists （P〈0.05）. Conclusion We should focus on the quality control of cancer chemotherapy in secondary hospitals, reinforce the training of oncology specialists, establish the admission system of oncologists, enhance the training of oncology clinical pharmacists and promote the standardization of cancer chemotherapy.