住院药房退药原因分析及综合应对措施的效果评价

The reasons of refund medicine in inpatient pharmacy and the evaluation of the effects of countermeasures

目的分析住院药房的退药原因并对应对措施的效果进行评价。方法将2016年10~12月设为对照阶段,将2017年10~12月设为观察阶段,分别在对照阶段内及观察阶段内未实施、实施综合应对措施,在2个阶段内参与综合应对措施的医院工作人员群体中各随机选取35人作为调查对象,且在两个时间段内选择退药涉及患者各40例开展退药情况满意度比较,分析两个时间段内退药原因、退药前五名科室比较、退药相关知识了解程度、退药满意度差异。结果住院药房退药原因可分为药房药品及厂家原因、临床科室原因、患者原因,共3大类,退药占比由高到低分别为患者原因、临床科室原因、药房药品及厂家原因,退药次数及比率分别为对照阶段232次42.80%、178次32.84%、132次24.35%,观察阶段287次48.47%、197次33.27%、108次18.24%;对照阶段退药次数较高前5位科室为呼吸科、心血管科、儿内科、重症医学科、普外科,观察阶段为儿内科、肿瘤内科、呼吸科、神经内科、重症医学科;观察阶段工作人员对退药相关知识问卷调查单项及总分均高于对照阶段(P<0.05);观察阶段退药总满意率高于对照阶段(P<0.05)。结论住院药房退药情况不能完全避免,应采取院级、临床科室、药房三方位综合应对措施,有助于提升工作人员对退药相关知识的了解程度,提高患者对退药服务的满意度。

Objective To investigate the reasons of refund medicine in inpatient pharmacy,and to evaluate the effects of countermeasures.Methods The duration from October 2016 to December 2016 were set as control phase,and the duration from October 2017 to December 2017 was set as observation phase.The comprehensive response measures that were not implemented and implemented were observed and compared between control phase and observation phase.In the two stages,the 35 subjects in each time phase were selected from hspital staff,who participated in the comprehensive response measures,moreover,the other 40 subjects in each time phse were selected who were involved in refund medicine.The reasons for refund medicine and the top five departments with refund medicine,understanding degree of refund medicine related knowledge,and satisfaction degree with refund medicine were analyzed and compared among the groups.Results The reasons for refund medicine in inpatient pharmacies could be divided into pharmacy medicines and manufacturer reasons,clinical department reasons,and patient reasons.There are 3 major categories.The proportion of refund medicine from high to low was patient’s reason,clinical department reason,pharmacy medicines and manufacturers reason.The number and ratio of refund medicine were 232 times 42.80%,178 times 32.84%,132 times 24.35%in control phase,287 times 48.47%,19733.27%,10818.24%in observation phase.Mopreover the top 5 departments with higher frequency of refund medicine in control phase were in order the respiratory department,cardiovascular department,pediatrics department,ICU,and department of general surgery,which in observation stage were pediatrics department,oncology depatment,respiratory department,neurology department,and ICU,In addition the total scores of hospital saff about refund medicine related knowledge in observation phase were significantly higher than those in control stage(P<0.05),and the total satisfaction degree of refund medicine in observation stage was significantly higher than that in control stage(P<0.05).Conclusion The refund medicine in inpatient pharmacies can not be completely avoided.The three-dimensional comprehensive response measures should be taken,which can improve the understanding degree of hospital staff about the knowledge of refund medicine,and can imporve the satisfaction degree of patients with refund medicine service.