临床药师参与计划性剖宫产临床路径制订与实施效果评价

Clinical Pharmacists’Participation in the Formulation and Implementation of Clinical Pathway of Planned Cesarean Section

目的探讨临床药师参与计划性剖宫产临床路径的制订与实施中的作用和效果。方法选取医院拟行计划性剖宫产患者150例,按临床药师是否参与临床路径的制订与实施分为对照组(2018年9月至12月,不参与)和观察组(2019年9月至12月,参与),各75例。比较两组患者的住院时间、住院费用、药品费用和药品不良反应,以及抗菌药物、宫缩剂、晶体液和中成药4类药物的使用合理性。结果与对照组比较,观察组患者的住院费用和药品费用均显著降低(P<0.05),抗菌药物预防用药时机不合理性显著降低(P<0.05),宫缩剂和中成药用药品种数均显著减少,宫缩剂、晶体液和中成药用药费用均显著降低(P<0.05),卡贝缩宫素和晶体液用药时间均显著缩短(P<0.05);两组患者住院时间和不良反应发生率比较,无显著差异(P>0.05)。结论临床药师通过参与临床路径制订与实施的全过程,可有效降低患者的住院费用,提高用药合理性。

Objective To investigate the role and effect of clinical pharmacists’participation in the formulation and implementation of the clinical pathway of planned cesarean section.Methods Totally 150 patients who would undergo planned cesarean section in our hospital were selected and divided into the control group(September to December 2018,non-participation)and the observation group(September to December 2019,participation)according to whether clinical pharmacists participated in the formulation and implementation of the clinical pathway,75 cases in each group.The hospitalization time,hospitalization cost,drug cost,adverse drug reactions,and the rationality of antibiotics,oxytocin,crystalloid solution and Chinese patent drugs in the two groups were compared.Results Compared with those in the control group,the hospitalization cost and drug cost in the observation group were significantly lower(P<0.05),the irrationality of the timing of prophylactic use of antibiotics in the observation group was significantly lower(P<0.05),the varieties of oxytocin and Chinese patent drugs were significantly fewer,the cost of oxytocin,crystalloid solution and Chinese patent drugs were significantly lower.There was no significant difference in hospitalization time and incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Clinical pharmacists can effectively reduce the hospitalization cost of patients and improve the rationality of drug use by participating in the whole process of formulation and implementation of the clinical pathway.