PDCA循环法改善住院患者静脉输液合理用药效果评价

Evaluation of Effectiveness of PDCA Cycle Method in the Improvement of the Rational Use of Intravenous Infusion in Inpatients

目的提升住院患者静脉输液合理用药水平。方法采用PDCA循环法对医院静脉输液的使用情况进行管控。收集复旦大学附属中山医院厦门医院2022年1月至6月(PDCA实施前)及2023年1月至6月(PDCA实施后)的住院患者静脉输液使用相关数据,以住院患者静脉输液使用率、平均每床日静脉输液使用量、平均每床日使用体积为主要指标,以非手术住院患者静脉输液使用率及住院患者抗菌药物、止吐药、中药注射剂、质子泵抑制剂(PPI)、肠外营养液静脉输液使用率为辅助指标评价管控效果。结果PDCA实施后,主要指标总体呈下降趋势,其中住院患者平均每床日使用体积为383.75 mL,显著低于PDCA实施前的683.11 mL(P<0.05)。辅助指标中,非手术住院患者静脉输液使用率及住院患者抗菌药物、止吐药静脉输液使用率均较PDCA实施前下降,其中住院患者止吐药静脉输液使用率下降显著(P<0.05);住院患者中药注射剂、PPI、肠外营养液静脉输液使用率均呈上升趋势,但无显著差异(P>0.05)。结论PDCA循环法能有效改善住院患者静脉输液的使用情况,提高其合理用药水平。

Objective To improve the rational use of intravenous infusion in inpatients.Methods The PDCA cycle method was used to control the use of intravenous infusion in the hospital.Data on the use of intravenous infusion in inpatients were collected from the Xiamen Branch of Zhongshan Hospital,Fudan University from January to June 2022(before the implementation of PDCA)and from January to June 2023(after the implementation of PDCA).The control effect was evaluated with the utilization rate of intravenous infusion,the average daily amount of intravenous infusion per bed,and the average daily volume of intravenous infusion per bed of inpatients as main indicators,and with the utilization rate of intravenous infusion in non-surgical inpatients,and the utilization rate of antibiotics,antiemetic drugs,traditional Chinese medicine injections,proton pump inhibitors(PPIs),and parenteral nutrition solution intravenous infusion in inpatients as the auxiliary indicators.Results After the implementation of PDCA,the main indicators showed an overall downward trend,with an average daily volume of 383.75 mL per bed for inpatients,which was significantly lower than 683.11 mL before the implementation of PDCA(P<0.05).In the auxiliary indicators,the utilization rate of intravenous infusion in non-surgical inpatients and the utilization rate of intravenous infusion of antibiotics and antiemetic drugs in inpatients were lower than those before the implementation of PDCA,and the utilization rate of intravenous infusion of antiemetic drugs in inpatients significantly reduced(P<0.05).The usage rate of traditional Chinese medicine injections,PPIs,and parenteral nutrition solution intravenous infusion in inpatients showed an upward trend,but there was no significant difference(P>0.05).Conclusion The PDCA cycle method can effectively improve the use of intravenous infusion in inpatients and the rational drug use level.