PDCA循环法改善眼科中心门诊处方质量效果分析  

Effect of PDCA Cycle on Improving the Quality of Outpatient Prescriptions in an Eye Center

作　　者：谢晓露[1] 李锦清 侯璇珠[1] 朱俊峰[1] XIE Xiaolu;LI Jinqing;HOU Xuanzhu;ZHU Junfeng(Joint Shantou International Eye Center,Shantou University and The Chinese University of HongKong,Shantou,Guangdong,China 515041)

机构地区：[1]汕头大学·香港中文大学联合汕头国际眼科中心,广东汕头515041

出　　处：《中国药业》2021年第9期11-14,共4页China Pharmaceuticals

基　　金：广东省汕头市科技计划医疗卫生项目[180725174011298]。

摘　　要：目的持续提高门诊处方质量。方法抽取眼科中心实施门诊处方PDCA循环管理模式实施前(2018年4月至9月,共80088张)和实施后(2018年10月至2019年3月,共78156张)的门诊电子处方,分析不合理处方质量改善情况。结果实施前,不合理处方1419张(17.72‰),其中不规范处方1073张(13.40‰),不适宜处方332张(4.15‰),超常处方14张(0.17‰);实施后,不合理处方839张(10.73‰),其中不规范处方588张(7.52‰),不适宜处方246张(3.15‰);超常处方5张(0.06‰)。与实施前比较,实施后临床诊断遗漏占比由3.47‰降至2.35‰,药品剂量或用法错误占比由3.80‰降至1.69‰,转抄错误占比由7.33‰降至4.54‰,重复用药占比由0.17‰降至0.06‰,处方后记医师未签名占比由1.10‰降至0.29‰,差异均有统计学意义(P<0.05);临床诊断不适宜占比由0.79‰升至0.87‰,差异无统计学意义(P>0.05)。结论应用PDCA循环法可提高门诊处方质量,加强技术及行政干预,事前、事后双向干预,加强与信息科、医务科、临床科室的沟通,充分利用信息化管理软件,可提高工作效率。第2次PDCA循环中,应继续加强行政干预,增加跟诊医师的用药及处方质量相关培训,将干预过程中电子信息系统出现的问题及时反馈给信息科,以不断优化电子处方的可操作性。Objective To improve the quality of outpatient prescriptions.Methods Outpatient electronic prescriptions were selected from an eye center before(from April 2018 to September 2018,a total of 80088 prescriptions)and after(from October 2018 to March 2019,a total of 78156 prescriptions)the implementation of the plan-do-check-act(PDCA)cycle management model of outpatient prescriptions,the quality improvement of irrational prescription was analyzed.Results Before the implementation,there were 1419(17.72‰)irrational prescriptions,including 1073(13.40‰)irregular prescriptions,332(4.15‰)unsuitable prescriptions and 14(0.17‰)abnormal prescriptions.After the implementation,there were 839(10.73‰)irrational prescriptions,including 588(7.52‰)irregular prescriptions,246(3.15‰)unsuitable prescriptions and 5(0.06‰)abnormal prescriptions.After the implementation,the proportion of clinical diagnosis omission decreased from 3.47‰to 2.35‰,the proportion of errors in dosage or usage decreased from 3.80‰to 1.69‰,the proportion of errors in transcription decreased from 7.33‰to 4.54‰,the proportion of repeated medication decreased from 0.17‰to0.06‰,and the proportion of prescriptions without doctors’signature decreased from 1.10‰to 0.29‰,which were significantly different from those before the implementation(P<0.05).The proportion of inappropriate clinical diagnosis increased from 0.79‰to 0.87‰,which had no significant difference compared with that before the implementation(P>0.05).Conclusion The application of PDCA cycle model can improve the quality of outpatient prescriptions,strengthen technical and administrative intervention,two-way intervention before and after the event,strengthen communication with the information department,medical department and clinical department,make full use of information management software,and improve work efficiency.In the second PDCA cycle,we should continue to strengthen administrative intervention,increase the training of follow-up physicians on the medicati

关 键 词：PDCA循环法 处方干预 处方质量 门诊处方 药事管理 

分 类 号：R95[医药卫生—药学]