我院在推进处方前置审核系统运行中存在的问题与对策
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篇名: 我院在推进处方前置审核系统运行中存在的问题与对策
TITLE:
摘要: 目的:推进处方前置审核工作的进行,促进患者的合理用药。方法:应用PDCA(Plan,Do,Check,Action)循环管理思想,在处方前置审核系统的运行中,针对审方工作模式的建立、审核系统中知识库规则的完善、药师审方能力的提高等问题,逐步实施3次PDCA循环以进行阶段性改进。通过比较运行处方前置审核系统前后门诊药房不合理处方率等指标评价该系统的运行效果。结果:通过采用“刚性”与“柔性”拦截相结合的处方审核模式、定期修改知识库规则、定期培训并考核审方药师等方法,处方前置审核系统顺利运行,处方前置审核工作在不断改进中推行,在3次PDCA循环中,不合理处方率明显降低,如在第1次PDCA循环后,中医科门诊不合理处方率由2017年1月的22.0%(1 393/6 332)降至2017年6月的7.4%(416/5 627);在第2次PDCA循环后,全院门诊不合理处方率由2018年3月的4.87%(5 244/107 691)降至2018年8月的2.21%(2 219/100 412);在第3次PDCA循环后,超疗程处方数占总处方数百分比由2018年6月的16.97%(15 728/92 684)降至2018年9月的5.55%(5 394/97 275)。结论:我院运行的处方前置审核系统可对不合理处方进行有效的拦截和干预,采用PDCA循环管理可有效推进处方前置审核工作的开展。
ABSTRACT: OBJECTIVE: To promote the implementation of the pre-prescription review work, and to ensure the rational drug use of patients. METHODS: With the idea of PDCA (Plan, Do, Check, Action) cycle management, the phased improvement of three PDCA cycles was gradually implemented in the operation of the pre-prescription review system, aiming at the establishment of the working mode of the prescription review work, the improvement of the rules of knowledge base in the review system and the improvement of the ability of pharmacists to review prescriptions. The operation results of the system were evaluated by comparing the irrational prescription rate of outpatient pharmacies before and after the operation of pre-prescription review system. RESULTS: Through adopting the prescription review mode of “rigid” and “flexible” interception, regular revision of knowledge base rules, regular training and examination of prescription pharmacists, pre-prescription review system operated smoothly, and the pre-prescription review work was carried out in the process of continuous improvement. In the three PDCA cycles, the irrational rate of prescriptions decreased significantly, such as after the first PDCA cycle, the irrational rate of TCM outpatient prescriptions decreased from 22.0% (1 393/6 332) in Jan. 2017 to 7.4% (416/5 627) in Jun. 2017; after the second PDCA cycle, the irrational rate of outpatient prescriptions in hospital decreased from 4.87% (5 244/107 691) in Mar. 2018 to 2.21% (2 219/100 412) in Aug. 2018. After the third PDCA cycle, the percentage of over-treatment course prescriptions in total prescriptions decreased from 16.97% (15 728/92 684) in Jun. 2018 to 5.55% (5 394/97 275) in Sept. 2018. CONCLUSIONS: The pre-prescription review system can effectively intercept and interfere with irrational prescriptions, and PDCA cycle management can effectively promote the operation of the pre-prescription review work.
期刊: 2019年第30卷第5期
作者: 廖丽娜,李鑫,左静,陈潞梅,张敏,邬蓉
AUTHORS: LIAO Lina,LI Xin,ZUO Jing,CHEN Lumei,ZHANG Min,WU Rong
关键字: 处方前置审核系统;知识库规则;审方;合理用药;PDCA循环管理
KEYWORDS: Pre-prescription review system; Knowledge base rules; Review prescription; Rational drug use; PDCA cycle management
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