持续质量改进在门急诊麻醉药品及第一类精神药品处方管理中的运用

Application of continuous quality improvement in the emergency management of narcotic drugs and the first-class of psychotropic drugs

目的观察持续质量改进在麻醉药品、第一类精神药品处方管理中的运用效果。方法医院自2016年开始对麻醉药品、第一类精神药品处方进行持续质量改进管理,随机抽取门急诊麻醉药品、第一类精神药品处方2015年453张、2016年512张、2017年569张,分析不合格处方存在的问题,评价持续质量改进管理的运用效果。结果2016年、2017年处方不合格率均低于2015年,差异均有统计学意义(P <0.05)。2015年不合格处方问题主要为缺项、未使用药品规范名称开具处方、无诊断或诊断用英文缩写; 2016年不合格处方问题主要为缺项、未使用药品规范名称开具处方、药品使用时间超过规定天数; 2017年不合格处方问题主要为缺项、药品使用时间超过规定天数、无诊断或诊断用英文缩写及药品用法与用量不适宜。2016年、2017年各问题类型处方占总处方数百分比均明显下降(P <0.05)。结论持续质量改进在门急诊麻醉药品、第一类精神药品处方管理中的运用效果显著,可明显减少不合格处方,值得广泛推广。

Objective To observe the effect of continuous quality improvement on the prescription management of narcotic drugs and psychotropic drugs.Methods Since 2016,the hospital has continued to improve the quality of prescriptions for narcotic drugs and first-class psychotropic drugs.Randomly selected prescriptions for narcotic drugs and first-class psychotropic drugs,2015（453 sheets）,2016（512 sheets） and 2017（569 sheets）,analyzed the problems of unqualified prescriptions and evaluate the effects of continuous quality improvement management.Results In 2016 and 2017,the rate of prescription disqualification was lower than that in 2015,and the differences were statistically significant（P〈0.05）.In 2015,the problem of unqualified prescriptions was mainly for the lack of prescriptions,the prescription of unused drug prescriptions,and the English abbreviation for no diagnosis or diagnosis.In 2016,the prescriptions were mainly for the missing,unused drug standard names,and the drug use time exceeded the specified number of days.In 2017,the problem of unqualified kitchens was mainly due to lack of items,drug use time exceeding the specified number of days,no abbreviation for diagnosis or diagnosis,and inappropriate use and dosage of drugs.In 2016 and 2017,the percentage of prescriptions for each type of problem decreased significantly（P〈0.05）.Conclusion The effect of continuous quality improvement on the prescription management of the first-class of psychotropic drugs is significant,which can obviously reduce the unqualified prescription and it is worth promoting.