骨科围手术期药物治疗路径的信息化建设与实施效果  

Information Construction and Implementation Effect of Perioperative Drug Treatment Pathways in Orthopedics

作　　者：刘月 杨钰华 周晓 李静 宋惠珠 LIU Yue;YANG Yuhua;ZHOU Xiao;LI Jing;SONG Huizhu(Department of Pharmacy,the Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi People's Hospital,Wuxi Medical Center,Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学无锡医学中心,无锡市人民医院,南京医科大学附属无锡人民医院药学部,无锡214023

出　　处：《医药导报》2024年第10期1700-1705,共6页Herald of Medicine

基　　金：无锡市科技发展资金资助项目(Y20212022);南京医科大学科技发展基金资助项目(NMUB20210326)。

摘　　要：目的探索建立一种信息化药物治疗路径管理新模式。方法通过多学科诊疗(MDT)制定骨科药物治疗路径,并借助信息系统实施路径管理,落实精细的管控规则。选取管理路径实施前(2022年1—5月)病例为对照组,管理路径实施后(2022年6—12月)病例为改进组,以评估管理效果。结果建立8大类手术的药物治疗路径,在医院信息系统(HIS)维护推荐药品医嘱990条,MINDS系统维护管控规则176条,应用药物治疗路径管理新模式后,骨科抗菌药物使用率、抗菌药物使用强度、住院次均药费和基药金额占比等指标均有明显改善;通过对路径实施前后病例分析,骨科抗菌药物、镇痛药物、补液扩容药物、抑酸护胃药物和活血消肿中成药使用合理率分别提高21.6%、12.7%、23.3%、32.1%和27.1%,平均药费分别降低111.51、15.33、49.84、42.29和14.23元。结论该院建立的以MDT为基础的药物治疗路径管理模式切实可行,相关经验可为医药同行提供参考。Objective To explore the establishment of a new model of informational drug treatment pathway management.Methods The orthopedic drug treatment pathways was developed through multidisciplinary diagnosis and treatment(MDT),and the pathway management was implemented with the help of an information systems to implement refined control rules.Cases before the implementation of the management pathway(January to May 2022)were selected as the control group,and cases after the implementation of the management pathway(June to December 2022)were selected as the improvement group to evaluate the management effectiveness.Results After establishing drug treatment pathways for 8 major types of surgeries,maintaining 990 medical prescriptions for recommended drugs in the HIS system,and 176 control rules in the MINDS system.There was a significant improvement in the orthopaedic department’s indexes of antimicrobial drug use rate,antibacterial drug use intensity,average inpatient medication cost,and percentage of the amount of basic medication after applying a new model of drug treatment pathway management.According to the case analysis before and after the implementation of the pathway,the rational rate of using orthopedic antibiotics,analgesics,fluid replacement and volume expansion drugs,acid inhibiting and stomach protecting drugs,blood activating and swelling-reducing proprietary Chinese medicines were increased by 21.6%,12.7%,23.3%,32.1%and 27.1%,respectively.The average drug costs was reduced by 111.51 yuan,15.33 yuan,49.84 yuan,42.29 yuan and 14.23 yuan,respectively.Conclusion The management mode of drug treatment pathway based on MDT established by our hospital is practical and effective,and the relevant experience may provide valuable insights for pharmaceutical peers.

关 键 词：多学科诊疗 药物治疗路径 信息化 合理用药 

分 类 号：R951[医药卫生—药学] R982