腹膜透析智慧化闭环药学服务的区域升级构建与效果分析

Construction and effect of regional upgrading of pharmaceutical care in intelligent closed-loop manage⁃ment of peritoneal dialysis

目的:区域升级构建腹膜透析智慧化闭环管理体系并进行效果评价,弥补现存腹膜透析管理模式的缺陷,促进腹膜透析药学服务发展。方法:借助PDCA工具,探索腹透液相关差错的主要因素,利用物联网和互联网相结合的技术手段,自行设计云透析运输管理系统,同时设立医院物流监管平台,对腹透液供应到患者终端反馈的全流程展开实时监控,并通过PowerBuilder自主研发腹透液登记系统。以此为基础,构建区域统一的可视化物流管理平台、全流程可监控的多维度查询平台以及大数据分析平台,优化医务人员培训体系,搭建区域MDT团队,中西医药护联动,线上线下服务患者。结果:区域内配送差错从92起/年降低至13起/年,登记时间从9.2 min缩短至1.6 min,配送时间从4.5 d缩短至2.1 d,相关投诉数量从56起/年降低至3起/年,区域宣教完成度从76%提升至98%、医务人员腹透操作规范度从86%提升至96%,患者及家属对腹透操作、相关用药的熟知度从70%提升至90%,患者满意度与依从性、医务人员满意度均有显著提升,差异均具有统计学意义。结论:本研究在腹膜透析智慧化闭环管理领域进行了深入探索并取得一定成效,在区域乃至全国范围得到推广,进一步保障患者的用药安全,提升药师的综合服务能力和水平,助力医疗机构对腹膜透析液的精准管理以及药师转型。

OBJECTIVE To upgrade the construction of the region intelligent closed-loop management system of peritoneal dialysis and evaluated the effect to make up for the defects of the existing management mode of peritoneal dialysis,and promote the development of peritoneal dialysis.METHODS With the help of PDCA tool,the main factors of errors related to peritoneal dialysis solution were explored,and the cloud dialysis logistics information system was designed by ourselves with the technical means of the combination of the Internet of Things and the Internet.Meanwhile,the hospital logistics supervision platform was set up to carry out real-time monitoring of the whole process of peritoneal dialysis solution supply,and the peritoneal dialysate management system was independently developed through PowerBuilder.Based on this,we build a unified regional visual logis⁃tics management platform and a multi-dimensional query platform that can monitor the whole process.On this basis,we also built a data analysis platform,optimize the training system for medical personnel,build a regional medical and drug combination,and integrate traditional Chinese and Western medicine to serve patients online and offline.RESULTS The number of delivery errors in the region decreased from 92 to 13 per year,the registration time decreased from 9.2 min to 1.6 min,the delivery time decreased from 4.5 d to 2.1 d,and the number of related complaints decreased from 56 to 3 per year.The completion degree of regional education increased from 76%to 98%,the standard degree of peritoneal dialysis operation of medical staff increased from 86%to 96%,the familiarity of patients and their families with peritoneal dialysis operation and related drugs increased from 70%to 90%,and the satisfaction and compliance of patients and satisfaction of medical staff were significantly improved.The differ⁃ences were statistically significant.CONCLUSION This study conducted an in-depth exploration of the intelligent closed-loop management of regional peritoneal dialysis and achieved certain results,which was promoted in the region and even the whole country to further ensure the drug safety of patients,improve the comprehensive service ability of pharmacists,and help medical institutions to accurately manage peritoneal dialysis fluid and promote the transformation of pharmacists.