PDCA循环管理干预促进临床中药注射剂合理使用的效果评价

Effects of PDCA Cycle Management Intervention on Promoting the Rational Use of Traditional Chinese Medicine Injections

目的评价PDCA循环管理干预对促进中药注射剂合理使用的效果。方法采用回顾性分析方法,从河源市中医院HIS中,随机抽取2017年上半年干预前、2017年下半年首轮干预后及2018年上半年第二轮干预后的合格出院病历各300份。结果经过两轮PDCA循环管理后,该院中药注射剂使用合理性显著提高,使用率从干预前的82.76%下降至58.67%、平均用药品种数从干预前的(1.40±0.64)种下降至(1.24±0.53)种、不合理使用率从干预前的45.33%下降至12.00%、中药注射剂费用占住院费用的比例从干预前的10.12%下降至7.99%、中药注射剂费用占药品费用的比例从干预前的28.25%下降至26.01%,差异均有统计学意义(P<0.05); ADR发生率从干预前的2.82%下降至2.27%。结论 PDCA循环管理促进了该院中药注射剂的合理使用,是药学干预管理的一种有效手段。

OBJECTIVE To evaluate the effects of PDCA cycle management intervention on promoting the rational use of traditional Chinese medicine injections( TCMIs). METHODS In the retrospective analysis,each 300 qualified discharge cases were randomly selected from the HIS before the intervention in the first half year of 2017,after the first intervention in the second half year of2017 and after the second intervention in the first half year of 2018. RESULTS After 2 cycles of PDCA cycle management,the rational use of TCMIs in the hospital had been significantly improved.The utilization ratio decreased from 82.76% to 58.67%,the average kinds of TCMIs decreased from( 1.40±0.64) kinds to( 1.24± 0.53) kinds,the unreasonable utilization ratio decreased from 45.33% to12.00%,the ratio of TCMIs expense to hospitalization expense decreased from 10. 12% to 7. 99%,the ratio of TCMIs expense to total medicine expense decreased from 28. 25% to 26. 01%,with statistical significance( P < 0. 05). The incidence of ADR decreased from2.82% to 2.27%. CONCLUSION PDCA cycle management improves the rational rate of TCMs in a hospital,it is an effective means of pharmaceutical intervention management.