基于工作分解结构的围手术期用药路径体系建设与实施效果  

Construction of perioperative clinical medicine pathway system based on work breakdown structure

作　　者：邢晓敏[1] 韩冰[1] 刘东华[1] 岳玥 朱莉 冷萍[1] 李静[1] Xing Xiaomin;Han Bing;Liu Donghua;Yue Yue;Zhu Li;Leng Ping;Li Jing(Department of Pharmacy,the Affiliated Hospital of Qingdao University,Shandong Province,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院药学部,青岛266000

出　　处：《药物不良反应杂志》2025年第1期30-35,共6页Adverse Drug Reactions Journal

基　　金：山东省医学会临床科研资金-齐鲁专项(YXH2022ZX02064)。

摘　　要：为促进围手术期合理用药,青岛大学附属医院采用工作分解结构(WBS)项目管理方法,构建了围手术期用药路径体系。该体系的建立需要完成路径需求调研、药物使用规范制定、药物治疗临床路径制定、临床沟通与培训、效果评价与监管、信息化用药监管和患者用药监测等7项任务,分别由不同专业的药师负责。历时4年,医院完成了抗菌、镇痛、静脉血栓栓塞预防、营养支持、气道管理药物和质子泵抑制剂等6条共性药物治疗临床路径体系的创建,对提升外科科室抗菌药物合理使用、优化患者术后疼痛管理和强化患者血栓形成风险评估等产生了显著成效。为心脏外科构建的个性化路径和对麻醉科实施的多维度药学干预也取得显著成效。因此,通过WBS构建围手术期用药路径体系,有助于细化工作任务分工,体现药师价值,提升围手术期药学服务质量。In order to promote rational drug use in perioperative period,a perioperative clinical medication pathway system was constructed in the Affiliated Hospital of Qingdao University using the project management method of work breakdown structure(WBS).To establish this system,the following 7 tasks should be completed:requirement investigation of the pathway,formulation of drug usage standards,formulation of clinical medicine pathways,clinical communication and training,effect evaluation and supervision,informazation of medication supervision,and therapeutic drug monitoring,which were implemented by pharmacists of different specialties,respectively.After 4 years of effort,6 general clinical medicine pathways were completed for antibiotics,analgesics,drugs in venous thromboembolism prophylaxis,nutritional support agents,airway management drugs,and proton pump inhibitors,respectively.These pathways had positive effects in improving the rational use of antibiotics,optimizing the postoperative pain management,and strengthening the risk assessment of thrombosis for patients in the surgical department.The personalized pathway constructed for the Cardiac Surgery Department and the multidimensional pharmaceutical intervention in the Anesthesiology Department also had remarkable effects.In conclusion,the construction of perioperative medication pathway system through WBS was helpful to refine the division of work tasks,reflect the value of pharmacists,and improve the quality of perioperative pharmaceutical services.

关 键 词：围手术期医护 临床路径 药学服务 工作分解结构 体系建设 外科药学 医院管理 

分 类 号：R47[医药卫生—护理学]