JCI标准下消化道恶性肿瘤患者口服化疗药管理流程再造  

Process reengineering of oral chemotherapy drug management by JCI standards for patients with gastrointestinal cancer

作　　者：殷文华[1] 冯玉玲[1] 范钰[1] 

机构地区：[1]江苏大学附属人民医院化疗科,江苏镇江212002

出　　处：《护士进修杂志》2015年第3期205-208,共4页Journal of Nurses Training

基　　金：江苏省"333"工程科研项目资助基金(BRA2012103);江苏省镇江市社会发展基金(编号:SH2011034)

摘　　要：目的探讨美国医疗机构评审联合委员会国际部(JCI)标准在口服化疗药管理中的流程再造,以提高口服化疗药安全给药品质。方法选择2013年1-3月在化疗科住院的消化道恶性肿瘤患者50例为对照组,2013年4-8月在化疗科住院消化道恶性肿瘤患者50例为实验组,应用JCI管理策略,对口服化疗药各环节进行流程再造,比较JCI实施前后医嘱不规范,漏服药差错,多服药差错,药房发药错误有关的不良事件发生例数。结果实施前医嘱不规范,漏服药差错,多服药差错,药房发药错误的发生为20、4、0、0例;实施后医嘱不规范,漏服药差错,多服药差错,药房发药错误降低到0、0、1、1例。实施前后实验组与对照组不良事件发生例数经秩和检验,(Z=-3.137,P<0.05),说明两组差异有统计学意义。实验组与对照组平均年龄经t检验,(P>0.05),说明两组年龄无统计学意义。实验组与对照组性别分布经χ2检验,(χ2=2.852,P>0.05),说明性别分布无明显差异,具有可比性。结论应用JCI标准对口服化疗药进行流程再造,能降低口服化疗药不良事件的发生率,提高口服化疗药安全给药品质。Abstract Objective To discuss the standards of the JCI in re-creating the process of the administration of oral chemotherapeutic drugs to improve the quality and safety of oral chemotherapeutic medicine. Method 50 patients with gastrointestinal cancer who received chemo therapy from January 2013 to March 2013 was selected as control group, and another 50 patients with the same illness who received chemo therapy from April 2013 to August 2013 as experimental group. Process reengineering of oral chemotherapy drug management was conducted by JCI＇s manage- ment method, and compared the numbers of mistakes that occurred before and after using the JCI＇s method in terms of un-standardized doctor＇s instructions, patients taking less or more medicine than prescribed and mistakes in the pharmacy. Result The numbers of unstandardized doctor＇s instructions, patients taking less medicine than pre- scribed, patients taking more medicine than prescribed and mistakes in the pharmacy were 20,4,0,0 respectively be- fore using the JCI＇s method. After applying the method, the numbers were 0,0,1,1 respectively . The sum test showed statistical significance between the total number of the 4 types of mistakes mentioned above that occurred be- fore and after using the JCI^s method（Z=-3. 137 ,P=0. 002〈0.05）. A t test on the average age of the patients in control and experimental group showed no statistical significance（P=0. 672〉0.05）. AX2（2 test on the sex distribu- tion of the twogroup showed no significant difference（X2=2. 852,P〉0.05）. Conclusion Process reengineering of o- ral chemotherapy drug management can reduce the risks of mistakes and improve the safety and quality of oral che- motherapeutic medicine.

关 键 词：消化道 恶性肿瘤患者 口服化疗药流程再造 

分 类 号：R471[医药卫生—护理学]