采用PDCA循环管理方法规范我院神经外科质子泵抑制剂合理用药的实践(1)
中圖分类号 R954；R969.3；R975 文献标志码 A 文章编号 1001-0408(2019)01-0010-05
DOI 10.6039/j.issn.1001-0408.2019.01.03
摘 要 目的：促进质子泵抑制剂(PPIs)在围手术期中的合理用药。方法：采用PDCA(Plan、Do、Check、Action)循环管理方法，收集我院神经外科围手术期PPIs使用的300份病历的不合理情况，分析原因、制订相应的管理目标及措施并实施，再与管理后神经外科围手术期PPIs 300份病历中的不合理使用率及不合理类型占比进行比较来评价管理效果。结果：通过采取收集相关资料确定应激性溃疡风险因素、建立围手术期预防使用PPIs的合理性评判标准、对医务人员开展合理用药培训、拟定各种管理制度、加强监督管理等措施，我院PPIs不合理使用率明显降低，不合理用药病历数由管理前的240例减少为156例，其中无指征预防用药率由37.33%降至29.00%(P<0.05)；给药剂量不合理率由11.33%降至6.33%(P<0.05)；给药频次不合理率由12.67%降至5.00%(P<0.01)。结论：我院采取的PDCA循环管理措施可规范神经外科围手术期PPIs的预防性使用，促进PPIs的合理使用。
关键词 PDCA循环管理；质子泵抑制剂；应激性溃疡；合理用药
Practice of Standardizing Rational Use of Proton Pump Inhibitors in Neurosurgery Department of Our Hospital by PDCA Cycle Management
CHU Jianjie1，DUAN Jialin1，DOU Fang1，LI Yuanyuan2，LI Weiwei1，FAN Tingting1，ZHAO Xian1，WANG Jingwen1，WEN Aidong1(1.Dept. of Pharmacy， Xijing Hospital， Air Force Military Medical University， Xi’an 710032， China；2.School of Basic Medicine and Clinical Pharmacy， China Pharmaceutical University， Nanjing 210009， China)
ABSTRACT OBJECTIVE： To promote rational use of proton pump inhibitors (PPIs) during perioperative period. METHODS： PDCA (Plan， Do， Check， Action) cycle management was used， the irrational use of PPIs of 300 medical records in neurosurgery department of our hospital were collected. The reasons were analyzed， management target was formulated and measures were implemented. The effects of management were evaluated through comparing the rate of irrational drug use and ratio of irrational type of PPIs in 300 medical records of neurosurgery department during perioperative period after management. RESULTS： Through collecting related data to confirm risk factors of stress ulcer， establishing rationality evaluation criteria for perioperative prophylactic use of PPIs， conducting rational drug use training among medical staff， drawing up various management systems and strengthening supervision and management， the rate of irrational use of PPIs was decreased significantly in our hospital； the number of irrational drug use cases decreased from 240 before management to 156 after management， among which the rate of prophylactic drug use without indication decreased from 37.33% to 29.00% (P<0.05)； the irrational dosage rate decreased from 11.33% to 6.33% (P<0.05)； the rate of irrational dosing frequency dropped from 12.67% to 5.00% (P<0.01). CONCLUSIONS： PDCA cycle management of our hospital can standardize the prophylactic use of PPIs in neurosurgery department during perioperative period and promote rational use of PPIs., 百拇医药(楚建杰 段佳林 窦芳 李媛媛 李韦韦 樊婷婷 赵先 王婧雯 文爱东)
DOI 10.6039/j.issn.1001-0408.2019.01.03
摘 要 目的：促进质子泵抑制剂(PPIs)在围手术期中的合理用药。方法：采用PDCA(Plan、Do、Check、Action)循环管理方法，收集我院神经外科围手术期PPIs使用的300份病历的不合理情况，分析原因、制订相应的管理目标及措施并实施，再与管理后神经外科围手术期PPIs 300份病历中的不合理使用率及不合理类型占比进行比较来评价管理效果。结果：通过采取收集相关资料确定应激性溃疡风险因素、建立围手术期预防使用PPIs的合理性评判标准、对医务人员开展合理用药培训、拟定各种管理制度、加强监督管理等措施，我院PPIs不合理使用率明显降低，不合理用药病历数由管理前的240例减少为156例，其中无指征预防用药率由37.33%降至29.00%(P<0.05)；给药剂量不合理率由11.33%降至6.33%(P<0.05)；给药频次不合理率由12.67%降至5.00%(P<0.01)。结论：我院采取的PDCA循环管理措施可规范神经外科围手术期PPIs的预防性使用，促进PPIs的合理使用。
关键词 PDCA循环管理；质子泵抑制剂；应激性溃疡；合理用药
Practice of Standardizing Rational Use of Proton Pump Inhibitors in Neurosurgery Department of Our Hospital by PDCA Cycle Management
CHU Jianjie1，DUAN Jialin1，DOU Fang1，LI Yuanyuan2，LI Weiwei1，FAN Tingting1，ZHAO Xian1，WANG Jingwen1，WEN Aidong1(1.Dept. of Pharmacy， Xijing Hospital， Air Force Military Medical University， Xi’an 710032， China；2.School of Basic Medicine and Clinical Pharmacy， China Pharmaceutical University， Nanjing 210009， China)
ABSTRACT OBJECTIVE： To promote rational use of proton pump inhibitors (PPIs) during perioperative period. METHODS： PDCA (Plan， Do， Check， Action) cycle management was used， the irrational use of PPIs of 300 medical records in neurosurgery department of our hospital were collected. The reasons were analyzed， management target was formulated and measures were implemented. The effects of management were evaluated through comparing the rate of irrational drug use and ratio of irrational type of PPIs in 300 medical records of neurosurgery department during perioperative period after management. RESULTS： Through collecting related data to confirm risk factors of stress ulcer， establishing rationality evaluation criteria for perioperative prophylactic use of PPIs， conducting rational drug use training among medical staff， drawing up various management systems and strengthening supervision and management， the rate of irrational use of PPIs was decreased significantly in our hospital； the number of irrational drug use cases decreased from 240 before management to 156 after management， among which the rate of prophylactic drug use without indication decreased from 37.33% to 29.00% (P<0.05)； the irrational dosage rate decreased from 11.33% to 6.33% (P<0.05)； the rate of irrational dosing frequency dropped from 12.67% to 5.00% (P<0.01). CONCLUSIONS： PDCA cycle management of our hospital can standardize the prophylactic use of PPIs in neurosurgery department during perioperative period and promote rational use of PPIs., 百拇医药(楚建杰 段佳林 窦芳 李媛媛 李韦韦 樊婷婷 赵先 王婧雯 文爱东)