PDCA循环干预促进上海市中医医院中药注射剂合理应用的效果探讨

Effects of PDCA Circulation Intervention on Promoting the Rational Application of Traditional Chinese Medicine Injection in Shanghai Municipal Hospital of Traditional Chinese Medicine

目的:探讨PDCA循环干预促进上海市中医医院(以下简称"我院")临床合理应用中药注射剂的效果。方法:通过医院信息系统调取2016年12月(干预前)我院出院病历1 825份、有效长期医嘱35 795条,针对中药注射剂临床应用不合理之处,应用PDCA循环法,通过计划、实施、检查和处理4个阶段进行有效干预;调取2017年6月(干预后)出院病历1 865份、有效长期医嘱37 004条,比较干预前后中药注射剂相关指标的变化情况。结果:采用PDCA循环法进行药学干预后,2017年6月我院中药注射剂的使用量、使用率和占住院费用的比例明显降低;用药合理性得到了显著的改善,无适应证用药、适应证不适宜、重复用药、病历中无用药记录、用法与用量错误、溶剂种类及用量错误等情况均有不同程度的改善。结论:采用PDCA循环法,通过药学干预可以提高合理用药水平,降低治疗费用。

OBJECTIVE： To probe into the effects of PDCA circulation intervention on promoting the rational application of traditional Chinese medicine（ TCM） injection in Shanghai Municipal Hospital of Traditional Chinese Medicine（ hereinafter referred to as＂our hospital＂）. METHODS： 1 825 discharged medical records and 35 795 effective long-term medical advices were extracted from hospital information system from our hospital in Dec. 2016（ before intervention）. In view of the irrational clinical application of TCM injection,the PDCA cycle method was used to effectively intervene in the four stages of plan,do,check and action. 1 865 discharged medical records and 37 004 effective long-term medical advices were extracted in Jun. 2017（ after intervention）,changes of related indicators of TCM injection were compared before and after intervention. RESULTS： After PDCA circulation on pharmaceutical intervention,the application amount,utilization ratio and cost proportion for hospitalization of TCM injection in our hospital in Jun. 2017 decreased dramatically. The rationality of medication has been significantly improved. The phenomenon as no indications for medication,inappropriate indications,repeated medication,medical records without any medication information,uncorrected usage and dosage,uncorrected categories and dosage of solvent had been improved with varying degrees. CONCLUSIONS： PDCA circulation method can improve rational medication and reduce treatment costs through pharmaceutical intervention.