PDCA循环管理处方点评工作在门诊中药饮片处方管理中的作用

Role of prescription comment of PDCA cycle management in the prescription management of Chinese herbal pieces in outpatient department

目的探讨PDCA循环管理处方点评工作在门诊中药饮片处方管理中的作用,为提高中药饮片处方的管理质量提供相关指导。方法选取2017年6月至2018年5月河源市中医医院实施常规管理的门诊中药饮片处方1200张为对照组,选取2018年6月至2019年5月我院实施PDCA循环管理的处方点评工作的门诊中药饮片处方1200张为研究组。对比两组的处方合格率及不合理处方发生情况。结果研究组的处方合格率为97.92%,明显高于对照组的85.08%,差异有统计学意义(P<0.05);研究组修改处方不规范、未标注特殊煎煮要求、用法不适宜、用药与证型不符、前记缺项与诊断无中医证型等不合理处方发生率分别为0.33%、0.17%、0.50%、0.58%、0.50%,明显低于对照组的3.08%、1.58%、4.33%、6.33%、5.08%,差异均有统计学意义(P<0.05)。结论PDCA循环管理的处方点评工作能提高中药饮片处方合格率,且减少不合理处方的发生频次。

Objective To explore the role of prescription comment of Plan-Do-Check-Act(PDCA)cycle management in the prescription management of Chinese herbal pieces in outpatient department,and to provide relevant guidance for improving the management quality of Chinese herbal pieces.Methods A total of 1200 prescriptions of Chinese herbal pieces implemented under routine management in Outpatient Department,Heyuan Hospital of Traditional Chinese Medicine from June 2017 to May 2018 were selected as the control group,and 1200 prescriptions of Chinese herbal pieces implemented under PDCA cycle management in Outpatient Department of the same hospital from June 2018 to May 2019 were selected as the study group.The qualified rate of prescriptions and the occurrence of irrational prescriptions were compared between the two groups.Results The qualified rate of the study group was 97.92%,which was significantly higher than 85.08%of the control group(P<0.05);the incidence of irrational prescriptions in the study group,such as nonstandard prescription modification,no special decoction requirements,inappropriate usage,medication inconsistent with syndrome type,lack of premonitory items,diagnosis without TCM syndrome type,were 0.33%,0.17%,0.50%,0.58%,0.50%,respectively,which were significantly lower than corresponding 3.08%,1.58%,4.33%,6.33%,5.08%in the control group(all P<0.05).Conclusion The prescription comment of PDCA cycle management can improve the qualified rate of Chinese herbal pieces,and reduce the occurrence frequency of unreasonable prescription.