多学科协作品管圈提升静脉用药调配中心处方前置审核质量实践与效果

Practice and Effect of Multidisciplinary Collaborative Quality Control Circle in Improving the Quality of Pre-Prescription Review in PIVAS

目的提升静脉用药调配中心(PIVAS)处方前置审核的质量,促进合理用药。方法由PIVAS审方药师-临床医师-护师-行政管理人员组建多学科协作品管圈(QCC),以“提高PIVAS不合理处方干预成功率”为主题开展活动,按活动步骤分析影响PIVAS不合理处方干预成功率的真因,拟订并实施相应对策,比较QCC活动开展前后的有形成果及无形成果,评价活动的开展效果。结果用药处方标准化、开展科室巡讲培训、完善处方审核标准、改进处方干预的沟通模式、加强药师培训等措施可有效干预不合理处方,为有效对策;PIVAS不合理处方干预成功率由QCC活动前的34.71%升至87.72%,升幅达152.72%;PIVAS处方不合理率由1.02%降至0.57%,降幅达44.12%。结论开展多学科协作QCC活动可有效提高PIVAS不合理处方的干预成功率,提升PIVAS处方前置审核质量,促进临床合理用药。

Objective To improve the quality of pre-prescription review in the pharmacy intravenous admixture service(PIVAS),and to promote rational drug use.Methods A multidisciplinary collaborative quality control circle(QCC)was established by prescription-review pharmacists in the PIVAS,clinical physicians,nurses,and administrative management personnel,with the theme of"improving the success rate of interventions for irrational PIVAS prescriptions".The root causes affecting the success rate of interventions for irrational PIVAS prescriptions were analyzed according to the activity steps,and corresponding countermeasures were formulated and implemented.The tangible and intangible results before and after the QCC activity were compared,and the effectiveness of the activity was evaluated.Results Measures such as standardizing medication prescriptions,conducting departmental lectures,improving prescription review criteria,enhancing communication modes for prescription intervention,and strengthening pharmacist training can effectively intervene in irrational prescriptions and serve as effective countermeasures.After the QCC activity,the success rate of interventions for irrational PIVAS prescriptions increased from 34.71%to 87.72%,with an increase of 152.72%;the irrational rate of PIVAS prescription decreased from 1.02%to 0.57%,with a decrease of 44.12%.Conclusion The multidisciplinary collaborative QCC activity can effectively improve the success rate of the intervention of irrational PIVAS prescriptions,enhance the quality of PIVAS pre-prescription review,and promote clinical rational drug use.