降低住院患者静脉输液使用率的“六步法”管理模式探索  

Exploration of“six-step”management mode to reduce the utilization rate of intravenous infusion in inpatients

作　　者：孙加琳[1] 李祥鹏[1] 倪倍倍[1] 邢晓敏[1] 张斌[1] 魏丽娜[1] 刘东华[1] 李静[1] SUN Jialin;LI Xiangpeng;NI Beibei;XING Xiaomin;ZHANG Bin;WEI Lina;LIU Donghua;LI Jing(Dept.of Pharmacy,the Affiliated Hospital of Qingdao University,Shandong Qingdao 266003,China)

机构地区：[1]青岛大学附属医院药学部,山东青岛266003

出　　处：《中国药房》2023年第10期1257-1261,共5页China Pharmacy

基　　金：国家自然科学基金资助项目(No.81903872);山东省中医药科技项目(No.Z-2022076);山东省药学会医院药学科研专项学术活动项目(No.yyyx2021qn-01)。

摘　　要：目的探索并建立一种医院静脉输液合理管控的长效机制。方法在建章立制的基础上,通过“六步法”核心技术策略的探索和实施,建立了静脉输液管控新模式,即第一步,无需静脉输液病种制定;第二步,可替代药品/剂型梳理;第三步,可替代用药途径梳理;第四步,用药规范制定;第五步,科室个性化用药需求探索;第六步,科室输液整合方案制定。以住院患者静脉输液使用率和住院患者平均每床日静脉输液使用量为主要指标评价管控效果。结果“六步法”管理模式在我院胸外科试点实施后,管控前后3个月的平均住院患者静脉输液使用率降低了1.74%,住院患者平均每床日静脉输液使用量降低了0.30袋/瓶,重点管控输液药品的人均用量逐渐下降。结论“六步法”管理模式可降低住院患者静脉输液使用率,该管理模式切实可行。OBJECTIVE To explore and establish a long-term mechanism for rational control of intravenous fluids in hospitals.METHODS On the basis of the establishment of rules and regulations,through the exploration and implementation of the core technical strategy of“six-step method”,a new mode of intravenous infusion control was established.The contents of the“six-step method”were as follows:the first step was to sort out the diseases that did not require intravenous infusion;the second step was to sort out the alternative drugs/dosage forms;the third step was to sort out the alternative routes of infusion;the fourth step was to develop drug specifications;the fifth step was to explore the personalized medication needs of clinical departments;the sixth step was to develop a department-specific integrated infusion regimen.The utilization rate of intravenous fluids in inpatients and the average daily amount of intravenous fluids per bed in inpatients were used as the main indicators to evaluate the control effect.RESULTS The comparison of the average values of three months before and after the implementation of the“six-step”management mode in the department of thoracic surgery of our hospital showed that after management and control,the average utilization rate of intravenous fluids in inpatients decreased by 1.74%,the average daily use of intravenous fluids in inpatients per bed decreased by 0.30 bags/bottle,and the per capita use of infusion drugs under key control gradually decreased.CONCLUSIONS The“six-step”management mode can reduce the utilization rate of intravenous fluids in inpatients,and this management mode is practical and feasible.

关 键 词：静脉输液使用率 输液管理 用药规范 

分 类 号：R95[医药卫生—药学]