基于持续质量改进理念的合理用药管理及成效分析

Management and Effectiveness Analysis of Rational Drug Use Based on CQI Wisdom

目的以某院急诊科为例,探讨医院合理用药管理的模式,并对其成效进行分析。方法运用持续质量改进(CQI)理念,药剂科与医务处联合干预,规范急诊科用药。首先调查急诊科门诊患者疾病谱,然后根据疾病筛选药物,明确需重点监控的药物,通过用量情况,找出异常增量药物进行处方点评,并针对不合理用药情况提出改进措施,最后再次点评,以评价成效。结果急诊科门诊患者所患疾病排名前三位的是:心血管系统疾病、神经系疾病、损伤中毒和其他外因后果。通过对注射用红花黄色素、醋酸钠林格注射液与果糖注射液、注射用奥美拉唑用药的点评与干预,减少了不合理用药情况。与2014年相比,2015年至2017年急诊科不合理用药情况明显改善,就诊患者人均药费逐年下降。结论持续质量改进的理念在促进我院急诊科合理用药方面发挥了积极作用,值得医院管理者改进医疗质量时借鉴。

Objective To explore the continuous improvement mode of rational drug use in emergency department of a hospital.Methods The mechanism of CQI combined with the establishment of joint intervention mechanism by pharmacy and medical department was used.Firstly,the emergency disease spectrum was analyzed.Then drugs were screened through diseases and abnormally increased drugs were found out.The evaluations prescriptions were statistically summarized by the pharmacist and intervention strategies were proposed.Finally,the effects before and after intervention were analyzed.Results The top three diseases of outpatient in emergency department were cardiovascular system,nervous system,trauma and poisoning.The irrational prescription was analyzed by pharmacy department such as safflower yellow injection,sodium acetateringer’s injection and fructose injection,omeprazole for injection.Compared with 2014,the emergency patients’personal drug cost rate declined year by year from 2015 to 2017.Conclusion The joint intervention mechanism plays an active role in promoting the rational use of drugs in the emergency department.It is worthwhile for hospital administrators to use for reference in improving medical quality.