持续改进门诊老年病人镇痛药处方在质量管理中的作用

Role of continuous quality improvement in quality management of analgesics prescriptions in elderly outpatients

目的探讨持续改进门诊老年病人镇痛药处方在质量管理中的作用。方法选取2018年1—6月河南省洛阳正骨医院(河南省骨科医院)门诊老年病人镇痛药处方作为对照组(活动前);选取2018年7—12月该院门诊老年病人镇痛药处方作为观察组(活动后),成立CQI管理活动小组进行干预。比较分析活动前后的镇痛药处方不合理情况、老年病人镇痛药不良反应发生情况及医务人员对镇痛药合理用药知识考核得分情况。结果活动后,门诊老年病人镇痛药处方不合格率由2.97%降为1.20%,差异有统计学意义(P<0.05);老年病人镇痛药不良反应事件占药品不良反应事件的比例由50.52%降为41.07%,差异有统计学意义(P<0.05);医务人员对镇痛药合理用药知识考核得分由(7.95±1.12)分提升到(13.30±1.71)分,差异有统计学意义(P<0.05)。结论持续改进门诊老年病人镇痛药处方可有效提高处方质量,促进镇痛药合理用药,保证医疗安全。

Objective To explore the role of continuous quality improvement(CQI)in quality management of analgesics prescrip tions in elderly outpatients.Methods The analgesics prescriptions in elderly outpatients in Henan Luoyang Orthopedic Traumato logical Hospital(Henan Orthopedic Hospital)from January to June 2018 were selected as control group(before activity).And the analgesics prescriptions in elderly outpatients in Henan Luoyang Orthopedic Traumatological Hospital(Henan Orthopedic Hospi tal)from July to December 2018 were selected as observation group(after activity),who were treated by CQI management.The rate of unreasonable analgesics prescriptions,adverse reactions in elderly patients and the scores of medical personnel on knowledge of rational drug use were analyzed and compared before and after the activity.Results The percentage of unreasonable analgesics pre scriptions in elderly outpatients reduced from 2.97%to 1.20%after the activity,the difference was statistically significant(P<0.05);the proportion of adverse reactions to analgesics in elderly patients decreased from 50.52%to 41.07%,the difference was sta tistically significant(P<0.05);the scores of medical personnel on knowledge of rational drug use of analgesics in elderly patients increased from(7.95±1.12)to(13.30±1.71),the difference was statistically significant(P<0.05);Conclusion Continuous quali ty improvement can effectively improve the quality of analgesic prescriptions in elderly outpatients,promote the rational drug use in hospitals,and ensure medical safety as well.