基于PASS处方点评与前置处方审核联合应用探讨PDCA循环管理法提高合理用药水平

Exploring the PDCA cycle management method to improve rational drug use based on the joint application of PASS prescription review and prescribing audit

目的以PASS处方点评和前置处方审核系统的应用为切入点,多学科协作持续改进,提高合理用药水平。方法通过多学科团队访谈总结北京市西城区广外医院合理用药管理存在的问题,采用PDCA循环管理法,针对存在的问题和不合理医嘱排名前3位的抗生素、非抗生素西药、中成药进行改进;以该医院2021年门急诊处方在前置处方审核系统、处方点评系统中的监测指标评价改进效果。结果2021年实施PDCA循环管理前后,第1~4季度前置处方审核系统审方药师干预率、药师干预后医师处方修改率、处方合格率均逐渐上升;处方点评系统中假阳性处方占比逐渐下降;第2季度较第1季度前置处方审核系统的问题处方占比、医师修改率有所上升,第3~4季度较第1季度又逐步下降。结论PDCA循环管理法的应用能有效提高该医院的合理用药水平。

Objective To use the application of the PASS prescription review and prescribing audit system as an entry point,multidisciplinary collaboration for continuous improvement,and in order to improve the level of rational drug use.Methods The problems of rational medication management in Guangwai Hospital,Xicheng District,Beijing were summarized through multidisciplinary team interviews,and the PDCA cycle management method was used to improve antibiotics,non-antibiotic western medicine,and proprietary Chinese medicine for the problems and the top three unreasonable medical prescriptions;the improvement effect was evaluated by the monitoring indexes of the hospital’s emergency and outpatient prescriptions in the prescription review system and prescription review system in 2021.Results Before and after the implementation of PDCA cycle management in 2021,the prescription review pharmacist intervention rate,the physician prescription revision rate after pharmacist intervention,and the prescription qualification rate of the prescribing review system gradually increased in the 1st to 4th quarters;the percentage of false-positive prescriptions in the prescription review system gradually decreased;the percentage of problematic prescriptions and the physician revision rate increased in the 2nd quarter compared with the 1st quarter of the prescribing review system,and then gradually decreased in the 3rd to 4th quarters compared with the 1st quarter.Conclusion The application of PDCA cycle management method can effectively improve the level of rational drug use in this hospital.