基于帕累托图优化儿科门急诊处方前置审核规则库的效果分析

Effect analysis of optimizing the pre-prescription review system rule library for pediatric outpatient and emergency prescriptions based on Pareto diagram

目的 基于帕累托图优化儿科门急诊处方前置审核规则库的效果,提升处方审核效率和质量,为医疗机构提供参考。方法 收集2023年1—12月青岛大学附属医院儿科门急诊处方前置审核系统的处方,根据处方前置审核系统规则库修改时间分为修改前和修改后。修改前为2023年1—6月规则库的处方,修改后为7—12月规则库的处方。根据修改前处方警示情况绘制帕累托图,采用二八法则查找主要警示原因,针对性优化规则,分析并比较规则库修改前后处方警示和点评情况,评价干预效果。结果 修改前处方警示1911条(5.93%),其中用法用量(38.67%,739/1911)和适应证(36.89%,705/1911)为主要问题。修改后处方警示551条(0.73%),其中用法用量(19.06%,105/551)和适应证(17.24%,95/551)均明显低于修改前,差异有统计学意义(P<0.01)。修改后处方警示率为0.73%,低于修改前的5.93%,差异有统计学意义(P<0.01)。修改后处方点评合格率为98.55%(12 417/12 600),高于修改前的98.05%(12 354/12 600),差异有统计学意义(P<0.05)。结论 利用帕累托图优化儿科门急诊处方前置审核规则库,可有效提升儿科处方前置审核的效率和质量,体现药师价值,保障儿童用药安全。

Objective To conduct an effect analysis of optimizing the pre-prescription review system rule library for pediatric outpatient and emergency prescriptions based on the Pareto diagram,and provide a reference for medical institutions.Methods Pediatric outpatient and emergency prescriptions were collected from the pre-prescription review system Affiliated Hospital of Qingdao University from January to December 2023,and divided into pre-modification and post-modification based on the modification time of the pre-prescription review system rule library.The pre-modification was from January to June,and the post-modification was from July to December.A pareto diagram was drawn based on the prescription warning situation of the pre-modification,and the main warning reasons were searched according to the 80 to 20 rule.The rules were optimized and the prescription warning and review situation of the pre-modification and post-modification was analyzed and compared to evaluate the intervention effect.Results As for the pre-modification,there were 1911 prescription warnings(5.93%),with the main issues being usage and dosage(38.67%,739/1911)and indications(36.89%,705/1911).As for the post-modification,there were 551 prescription warnings(0.73%),among which the usage and dosage(19.06%,105/551)and indications(17.24%,95/551)were significantly lower than those before modification,with statistical significance(P<0.01).The post-modification prescription warning rate of 0.73%was lower than that of the pre-modification prescription warning rate of 5.93%,the difference was statistically significant(P<0.01).The qualified rate of the post-modification prescription review was 98.55%(12417/12600),which was higher than that of the pre-modification prescription review(98.05%,12354/12600),and the difference was statistically significant(P<0.05).Conclusion Using Pareto diagrams to optimize the pre-prescription review system rule library for pediatric outpatient and emergency prescriptions can effectively improve the efficiency and quality of the pre-prescription review system,reflect the value of pharmacists,and ensure the safety of children's medication.