PDCA循环管理在规范痴呆伴睡眠障碍患者苯二氮䓬类药物合理使用中的效果  

Application of PDCA cycle management on the rational use of benzodiazepines in dementia patients with sleep disorders

作　　者：慕永刚 那万秋[1] 陈科[1] 潘新根[1] 陈小郧[1] 支胜利[1] 陈浙丽[1] MU Yong-gang;NA Wan-qiu;CHEN Ke;PAN Xin-gen;CHEN Xiao-yun;ZHI Sheng-li;CHEN Zhe-li(Department of Geriatric Psychiatry,Huzhou Third Municipal Hospital,Huzhou,Zhenjiang 313000,China)

机构地区：[1]湖州市第三人民医院,浙江湖州313000

出　　处：《阿尔茨海默病及相关病杂志》2021年第1期28-32,共5页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：浙江省基础公益研究计划(LGF18H250001)。

摘　　要：目的:评价PDCA循环管理在规范痴呆伴睡眠障碍患者苯二氮䓬类药物合理性使用的效果,提高痴呆伴睡眠障碍苯二氮䓬类药物合理使用的规范化水平。方法:回顾性分析2018年8月-2018年11月期间在我院老年精神科住院的痴呆伴睡眠障碍患者中苯二氮䓬类药物使用现状作为基线数据,于2018年12月至2020年1月运用PDCA循环管理法制定痴呆伴睡眠障碍苯二氮䓬类药物治疗的规范路径,执行改进措施,比较PDCA循环前后痴呆伴睡眠障碍的睡眠状况评估率、痴呆伴睡眠障碍苯二氮䓬类药物治疗规范合理性使用率和苯二氮䓬类药物使用中不良反应发生率。结果:经过4至7个阶段的PDCA循环管理干预后,痴呆伴睡眠障碍患者的睡眠评估率由7.1%(4/56)上升至98.0%(99/101),差异有统计学意义(P<0.01);痴呆伴睡眠障碍患者苯二氮䓬类药物使用的规范合理性使用率由44.7%(25/56)上升至99.0%(100/101),差异有统计学意义(P<0.01);痴呆伴睡眠障碍患者苯二氮䓬类药物使用中药物相关不良事件发生率下降,差异有统计学意义(P<0.05)。结论:PDCA循环管理能有效提高痴呆伴睡眠障碍患者苯二氮䓬类药物的规范合理性使用率,值得临床实践中推广。Objective:To evaluate the effect of PDCA cycle management to improve the rational use of benzodiazepines for dementia patients with sleep disorders.Method:In November 2018,the quality assessment group was set up and analyzed the situation of benzodiazepines for dementia patients with sleep disorders during the last four months.The use of benzodiazepines was managed using PDCA cycle from December 2018 to January 2020.The rate of assessment in sleep,rational use of benzodiazepines and incidence rate of adverse effects were compared before and after implementation of PDCA cycle.Results:After 4 to 7 PDCA cycles,the evaluation rate of sleep disorders in patients with dementia increased from 7.1%to 98.0%(P<0.01),and the rational use of benzodiazepines in dementia with sleep disorders increased from 44.7%to 99.0%(P<0.01).The total adverse effects rate dropped significantly(P<0.05).Conclusion:The PDCA cycle can effectively promote the rational use of benzodiazepines in dementia with sleep disorders,which is worth popularizing in clinical practice.

关 键 词：PDCA 痴呆 睡眠障碍 苯二氮䓬 

分 类 号：R749[医药卫生—神经病学与精神病学]