心脏瓣膜疾病抗凝治疗的医护药共同管理模式的实践  

The Practice of Joint Anticoagulant Management for Patients with Heart Valve Disease

作　　者：项梅 秦春香[1] XIANG Mei;QIN Chunxiang(Xiangya Nursing School of Central South University,Changsha,Hunan 410013,China;Hainan General Hospital,Haikou,Hainan 570311,China)

机构地区：[1]中南大学湘雅护理学院,湖南长沙410013 [2]海南省人民医院,海南海口570311

出　　处：《今日药学》2020年第4期265-267,共3页Pharmacy Today

基　　金：海南省卫生厅基金资助项目(19A200050)。

摘　　要：目的探索实践抗凝治疗的医护药共同管理模式。方法针对心脏瓣膜疾病患者住院期间和出院后的抗凝治疗,探索医护药共同管理模式:医生通过制定围术期抗凝方案、抗凝宣教、门诊+微信群进行抗凝管理;护士通过向患者解释、指导、执行抗凝方案、护士查房、VTE评估、出院宣教、电话随访+上门随访进行抗凝管理;临床药师通过药师查房、宣教、审核医嘱、联合门诊进行抗凝管理。结果通过临床反复的探索和实践,某院将临床药师纳入到抗凝管理团队,宣教重心前移,同时加强住院期间和出院后医护药合作、细化分工,建成了较为科学的医护药共同管理模式,显著提高了患者的华法林抗凝知识,提高了患者的抗凝依从性。结论医护药共同管理模式覆盖抗凝治疗的全过程,提高了抗凝管理的安全系数,有非常大的临床应用价值。OBJECTIVE To explore the joint management mode of anticoagulant therapy participated by doctors,nurses and pharmacists.METHODS The joint anticoagulant management mode for patients with heart valve disease during hospital and discharge was explored:doctors conduct anticoagulant management by formulating perioperative anticoagulant program,anticoagulaneducation,and outpatient clinic+Wechat group.Nurses conducted anticoagulant management by explaining,guiding and implementing anticoagulant program to patients,rounds of ward,VTE evaluation,discharge propaganda and education,telephone follow-up+on-site follow-up.The clinical pharmacists carried out the anticoagulant management through the pharmacists’rounds,propaganda and education,checking doctor’s orders,and the joint outpatient service.RESULTS Through repeated clinical practice,clinical pharmacists became a member of anticoagulant team which made medication propaganda forward,and strength the cooperation between doctors and nurses,and refine the division of anticoagulant,and improved the joint anticoagulant team building.Joint anticoagulant management significantly improved patients’compliance and knowledge of warfarin anticoagulant.CONCLUSION Doctors,nurses and pharmacist co-participated in whole anticoagulant process,which improved the safety of anticoagulant,and have higher clinical value.

关 键 词：医护药共同管理模式 抗凝治疗 管理模式 

分 类 号：R969[医药卫生—药理学]