基于六西格玛管理构建中药注射剂联合使用药学监护策略

发布时间：2018-03-27 08:55

本文选题：联用　切入点：六西格玛　出处：《北京中医药大学》2017年硕士论文

【摘要】：目的:目前,临床中药注射剂的联合使用十分普遍,联用的合理性关系到患者的生命安全。因此,必须加强对中药注射剂合理用药的监管,避免由于不合理联用引发的药物不良事件的发生。本研究以门诊处方点评为切入点,对中药注射剂临床用药过程实施监测、评价和超常预警,以初步建立符合临床实际、便于操作的药学监护范式,确保临床用药安全。方法:本研究采用以下2种方法:(1)文献研究法:查阅相关文献及药品说明书,全面的了解中药注射剂的配伍禁忌(相互作用)。(2)六西格玛管理法:通过对我院门诊处方的分析,引入六西格玛管理理念,制定相应的药学监护策略。结果:本研究共抽查门诊中药注射剂处方1487张,干预前处方合格率97.70%,干预前不合理联用的主要科室是急诊、神经内科。不合理联用主要问题是药品超剂量、溶媒选择及用量错误、无间隔液体、同类中药联用。因此,重点针对这些科室的问题实施监控。通过六西格玛模式对我院处方进行点评及干预,使干预后的处方合格率达到99.73%。结论:本研究立足于医院中药注射剂的合理应用,开展了医院中药注射剂联用的药学监护探索工作。通过文献研究及院内的用药情况调查,制定了符合临床实际、可操作的药学监护措施,用于实践取得了良好的干预效果,不仅提高了临床医生安全合理用药的认识,同时提高了医院合理用药的水平,降低了不良反应发生的风险。由于目前中药注射剂联合应用的药学监护尚在初始阶段,所以本次研究引入六西格玛管理理念参与制定中药注射剂临床联用的药学监护策略具有创新性。本研究受多种条件限制,存在一定的局限性。今后,随着我院信息系统的完善,进一步深入系统的研究有待继续。同时,中药注射剂的说明书存在诸多问题,这就需要临床药师必须对相关文献进行实时追踪,确保药学监护的实用性、有效性。
[Abstract]:Objective: at present, the combined use of traditional Chinese medicine injection is very common, and the rationality of the combination is related to the life safety of patients. Therefore, it is necessary to strengthen the supervision on the rational use of traditional Chinese medicine injection. To avoid the occurrence of adverse drug events caused by irrational combination of drugs, this study, based on the outpatient prescription evaluation, carried out monitoring, evaluation and abnormal early warning of the clinical drug use process of traditional Chinese medicine injection, so as to establish a preliminary clinical reality. A convenient pharmacological monitoring paradigm to ensure the safety of clinical drug use. Methods: in this study, the following two methods were used: literature research method: consulting related literature and drug instructions, Comprehensive understanding of traditional Chinese medicine injection compatibility taboo (interaction. 2) six Sigma management method: through the analysis of outpatient prescriptions in our hospital, the introduction of six Sigma management concept, Results: a total of 1487 prescriptions of traditional Chinese medicine injection were randomly checked in this study. The qualified rate of prescriptions before intervention was 97.70. The main department of irrational combination before intervention was emergency department. Department of Neurology. The main problems of irrational combination use are overdose of drugs, wrong choice and dosage of solvent, no interval liquid, combined use of the same kind of traditional Chinese medicine. Through the six Sigma model, the prescription qualification rate of our hospital reached 99.733.Conclusion: this study is based on the rational application of traditional Chinese medicine injection in hospital. Through the literature study and the investigation of the drug use in the hospital, the pharmaceutical monitoring measures which accord with the clinical practice and can be operated have been formulated, and the good intervention effect has been obtained in the practice. It not only improves the understanding of safe and rational use of drugs by clinicians, but also raises the level of rational use of drugs in hospitals and reduces the risk of adverse reactions. At present, the pharmaceutical monitoring of the combined application of traditional Chinese medicine injections is still in the initial stage. Therefore, this study introduces six Sigma management concept to participate in the formulation of traditional Chinese medicine injection clinical combined pharmaceutical monitoring strategy is innovative. This study is limited by a variety of conditions, there are certain limitations. In the future, with the improvement of information system in our hospital, At the same time, there are many problems in the specification of traditional Chinese medicine injection, which requires clinical pharmacists to track the relevant documents in real time to ensure the practicability and effectiveness of pharmaceutical monitoring.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R288

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