失效模式与效应分析在高血压患者慢病药学服务中的效果评价

Effect evaluation of failure mode and effect analysis for pharmaceutical care of hypertensive patients

目的探讨失效模式与效应分析(FMEA)模式在南京医科大学第四附属医院高血压慢病药学服务中的应用效果。方法选取心内科入院诊断为原发性高血压,于2021年1月—6月出院的患者130例为对照组,于2021年7月—12月出院的患者130例为干预组。对照组按照常规方法进行高血压慢病药学服务并在出院第3、6个月进行随访。干预组在对照组的基础上运用FMEA模式进行慢病药学服务改进工作。对比两组患者的临床结局和人文效果。结果干预组患者的血压达标例数、依从性、高血压疾病及用药认知评分和生活方式改善例数均高于对照组(P<0.05),在出院后第3、6个月随访时,干预组药物治疗相关问题以及不良反应发生率均低于对照组(P<0.05)。结论该院在高血压慢病药学服务实施中应用FMEA,分析各类风险失效模式,制订慢病药学服务过程改进措施,提高了用药安全性和药学服务质量。

Objective To evaluate the application of failure mode and effect analysis(FMEA)in the pharmaceutical care of patients with chronic hypertension in the Fourth Affiliated Hospital of Nanjing Medical University.Methods Totally 130 patients with primary hypertension admitted to the Department of Cardiology and discharged from January to June 2021 were selected as the control group.Another 130 patients discharged from July to December 2021 were selected as the intervention group.The control group was provided with hypertension and chronic disease pharmaceutical care according to the routine and was followed up at the 3rd and 6th months after the discharge.The intervention group used the FMEA to improve the chronic disease pharmaceutical service in addition to service for the control group.The clinical outcomes and humanistic effects of the two groups were compared.Results The number of patients in the intervention group who reached standard blood pressure,compliance,hypertensive disease score,medication cognitive score and lifestyle improvement was more than that in the control group(P<0.05).At the follow-up of 3 and 6 months after the discharge,the incidence of treatment related problems and adverse reactions in the intervention group was lower than that in the control group(P<0.05).Conclusion FMEA in the implementation of pharmaceutical care for patients with chronic diseases such as hypertension,improves drug safety and pharmaceutical care quality.