帕累托图联合鱼骨图分析法在重点监控药品用药改进中的应用

Application value of pareto diagram combined with fishbone diagram in improving rational administration of key monitoring drugs

目的:探讨帕累托图联合鱼骨图分析法在重点监控药品合理用药改进中的应用价值。方法:随机抽取某医院2018年6月-2019年6月期间及2019年7月-2020年7月期间应用《第一批国家重点监控合理用药药品目录》中公布的重点监控药品出院病历各300份,采用帕累托图分析不合理用药的因素类型,再应用鱼骨图进行根因分析。比较整改措施实施前后不合理用药的改善情况。结果:整改措施实施前,重点监控药品不合理用药率达51.67%,整改措施实施后,不合理用药率为11.67%,显著低于整改措施实施前(P<0.05),重点监控药品使用金额在药品使用总金额中的占比以及人均药费均显著低于整改措施实施前。结论:帕累托图联合鱼骨图分析法有利于全面了解不合理用药的类型分布和根本原因,有助于整改措施的制定和实施。

Objective:To explore the application value of Paretotu combined with fish bone map analysis in the improvement of rational drug use.Methods:We randomly selected 300 medical records of key discharge drugs from the period of June 2018 and July 2019 and July 2019 and July 2020 for the analysis of factors,and root cause analysis.Compare the improvement of unreasonable drug use before and after the implementation of the rectification measures.Results:Before the implementation of the rectification measures,the rate of the key monitored drugs reached 51.67%.After the implementation of the rectification measures,the rate was 11.67%,significantly lower than that of the implementation of the rectification measures(P<0.05).The proportion of the key monitored drugs and the per capita drug cost were significantly lower than that of the rectification measures.Conclusion:Paretotu combined with fish bone map analysis is helpful to fully understand the type distribution and root causes of irrational drug use,and facilitate the formulation and implementation of corrective measures.