多学科合作优化住院部退药模式效果评价

Effect of Multidisciplinary Cooperation on Optimizing Drug Withdrawal Mode in Inpatient Department

目的评价多学科合作优化住院部退药的效果。方法针对传统退药模式存在的问题,组建住院部退药改善项目多学科团队(MDT),分析退药原因,规范退药管理,优化退药流程,完善医院药品信息系统,引入退药冲减功能,建立住院病区电子化退药操作系统,干预住院部退药。对比MDT干预前(2020年1月)、干预后(2020年6月至8月)退药相关指标。结果与干预前比较,干预后月均退药量减少10%,月均退药率逐日降低,退药冲减率约为70%且逐月升高。退药返架差错干预前为5例,干预后为1例(仅2020年6月出现)。干预后月均可控因素退药较干预前减少169例次,占比降低7.79%。每日累计退药耗时,护士减少20.88 h,药师减少3.70 h。患者出院因退药而等候的时间平均缩短18.71 min。结论通过建立MDT,以管理措施和信息技术为抓手,可有效解决住院部的退药问题,提升药学服务质量。但应注意保证合理的退药。

Objective To evaluate the effect of multidisciplinary cooperation on optimizing drug withdrawal model in inpatient department.Methods In view of the problems of the traditional drug withdrawal model,a multidisciplinary team(MDT)for the improvement project of drug withdrawal model in the inpatient department was established to analyze the causes of drug withdrawal,standardize the drug withdrawal management,optimize the drug withdrawal process,improve the hospital drug information system,introduce the drug withdrawal flunking-reduction function,establish an electronic drug withdrawal operation system in the inpatient ward,and intervene the drug withdrawal in the inpatient department.The relevant indicators of drug withdrawal before MDT intervention(January 2020)and after intervention(from June to August 2020)were compared.Results Compared with those before the intervention,the average monthly drug withdrawal rate decreased by 10%,which decreased month by month,and the write-off rate of the drug withdrawal of the system was nearly 70%,which increased month by month.There were five cases of drug withdrawal errors before the intervention and one case after the intervention(only in June 2020).After the intervention,the average monthly drug withdrawal induced by controllable factors decreased by 169 cases,accounting for 7.79%.The cumulative daily drug withdrawal time was reduced by 20.88 h for nurses and 3.70 h for pharmacists.The patient’s waiting time for discharge was reduced by 18.71 min due to the drug withdrawal.Conclusion The establishment of MDT can effectively solve the problem of drug withdrawal in the inpatient department and improve the quality of pharmaceutical care with the management measures and information technology as the starting point,but attention should be paid to ensuring reasonable drug withdrawal.