帕累托图联合鱼骨图分析法在静脉用药调配中心中药注射剂医嘱质量持续改进中的应用  

Application of continuous quality improvement in irrational prescriptions of traditional Chinese medicine injections in pharmacy intravenous admixture services through Pareto chart and fishbone diagram analysis

作　　者：吴德跃 王吉娥 赵声定 李正富 赵丹 秦霞 孙帮燕 龚青云 WU Deyue;WANG Jie;ZHAO Shengding(Pharmacy intravenous admixture services,the First People’s Hopital of Zhaotong,Zhaotong 657000,China;不详)

机构地区：[1]昭通市第一人民医院静脉用药调配中心,云南昭通657000 [2]昭通市中医医院重症医学科,云南昭通657000

出　　处：《中国处方药》2025年第4期12-15,共4页Journal of China Prescription Drug

摘　　要：目的通过对静脉用药调配中心(PIVAS)中药注射剂不合理医嘱统计分析并提出整改措施,提高合理用药水平,促进临床合理使用中药注射剂。方法收集2021年4月~2022年4月PIVAS干预的中药注射剂不合理医嘱资料进行回顾性统计分析,通过绘制帕累托图找出不合理医嘱用药类型,再运用鱼骨图分析法找出不合理用药的根本原因,制定措施,持续改进。结果不合理用药类型中,溶媒剂量不当(占29.79%)、溶媒选择不当(占24.11%)及录入错误(占19.86%)为主要因素;配伍不当(占11.70%)为次要因素;用法不当(占9.22%)及给药剂量不当(占5.32%)为一般因素。结论应用帕累托图联合鱼骨图分析法,可快速、简单地发掘不合理用药医嘱中的主要因素并进行干预,有效促进中药注射剂合理使用质量的持续提升,确保患者用药安全。Objective To improve the level of rational drug use and promote the rational clinical use of traditional Chinese medicine(TCM)injections by statistically analyzing and proposing rectification measures for irrational prescriptions of TCM injections in pharmacy intravenous admixture services(PIVAS).Methods The data of irrational prescriptions by PIVAS from April 2021 to April 2022 were collected and analyzed retrospectively.The types of irrational prescriptions were identified through Pareto chart.Then the root reasons of the irrational medication were found out through fishbone diagram.Measures were formulated and continuous improvement was carried out.Results The main factors of irrational drug use were improper solvent dosage(29.79%),improper solvent selection(24.11%)and inputting errors(19.86%)according to irrational drug use types.The secondary factors was the improper compatibility of medicines(11.70%).The general factors were the improper usage of medicines(9.22%)and improper dosage of medicine(5.32%).Conclusion The application of Pareto chart combined with fishbone diagram analysis method can quickly and simply identify the main factors in irrational prescriptions,which is convenient for pharmacists to intervene and improve the level of rational use of drugs on TCM injections and ensure the medication safety.

关 键 词：帕累托图 鱼骨图 静脉用药调配中心 中药注射剂 不合理医嘱 合理用药 

分 类 号：R288[医药卫生—中药学]