PDCA循环管理在某院门诊处方干预中的应用

发布时间：2018-02-13 02:57

  本文关键词： PDCA循环管理 处方干预 合理用药 门诊处方　出处：《中国药房》2017年08期 　论文类型：期刊论文

【摘要】：目的:评价PDCA循环管理在门诊处方干预中的应用效果。方法:选取某院2014年1-12月门诊处方895 360张(干预前组)和2015年1-12月门诊处方918 659张(干预后组),对实施PDCA循环管理前后的门诊不合理处方进行分析,并比较用法用量不适宜、临床诊断书写不全、医师处方未签名(章)或与留样不一致等核心指标改善情况。结果:干预前,不合理处方共2 347张,包括不规范处方1 401张、不适宜处方849张和超常处方97张。干预后,不合理处方共1 161张,包括不规范处方695张、不适宜处方425张和超常处方41张,分别较干预前组下降了50.53%、50.39%、49.94%和57.73%;用法用量不适宜、临床诊断书写不全、医师处方未签名(章)或与留样不一致、处方用纸不规范、适应证不适宜、处方修改未签名并注明修改日期或药品超剂量使用未注明原因和再次签名、无特殊情况门诊处方超7 d常用量或急诊处方超3 d常用量等占门诊处方总量的比例分别由干预前的0.72‰、0.57‰、0.45‰、0.27‰、0.20‰、0.19‰和0.15‰降至0.32‰、0.25‰、0.19‰、0.11‰、0.09‰、0.08‰和0.07‰。结论:PDCA循环管理用于门诊处方质量改进效果显著。该院门诊处方仍存在不合理现象,有待持续干预。
[Abstract]:Objective: to evaluate the effect of PDCA circulation management on outpatient prescription intervention. Methods: select 895,360 out-patient prescriptions from 2014 to December in a hospital (pre-intervention group) and 918,659 out-patient prescriptions from January to December on 2015 (post-intervention group), and to implement PDCA. The irrational prescriptions before and after circulation management were analyzed. Results: before intervention, there were 2 347 unreasonable prescriptions, including 1 401 irregular prescriptions. After intervention, there were 1 161 unreasonable prescriptions, including 695 non-standard prescriptions and 41 unsuitable prescriptions, which were 50.53%, 59.94% and 57.73% lower than those before intervention, respectively. The clinical diagnosis is incomplete, the doctor's prescription is not signed (chapter) or inconsistent with the retained sample, the prescription paper is not standardized, the indication is not suitable, the prescription modification is not signed and the date of modification or the drug overdose is used without indicating the reason and the re-signature, The proportion of outpatient prescriptions over 7 days or emergency prescriptions more than 3 days in total outpatient prescriptions decreased from 0.72 鈥，

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