摘要
目的探讨应用PDCA循环管理工具对我院药品不良反应（ADR）报告和监测管理工作持续质量改进的效果,使ADR报告和监测工作管理规范化,提高管理质量,促进临床合理用药。方法 应用PDCA循环管理的4个关键步骤（计划、实施、检查、处理）的管理方法,分析我院ADR监测工作中存在的问题并查找原因,制定解决问题的计划并实施,在反复的检查过程中再发现问题、再改进、再提高,最终达到规范化的管理。结果 实施PDCA循环管理后,通过建立药品ADR监测与上报工作管理体系,采取有效措施,落实ADR报告与监测,2015年我院ADR上报总量、医务人员上报量、记录于电子病历数、上报科室分别增长了558.0%、33.3%、1288.0%、200.0%,干预有效（P〈0.05）;首次用药最易发生ADR,干预后用药1-3 d、用药4-10 d导致ADR占比分别增加116.4%、320.7%,干预有效（P〈0.05）;静脉、口服给药仍远高于其他给药方式,但静脉注射导致ADR占比下降了16.3%,静脉注射干预有效（P〈0.05）;抗感染物导致的ADR占比下降了63.6%,干预有效（P〈0.05）;中药注射剂导致的ADR占比上升了70.3%,差异无统计学意义（P﹥0.05）;皮肤及附件器官损害仍最多,但导致ADR占比下降了18.7%,差异无统计学意义（P〉0.05）,增加了肝胆及胃肠系统损害等严重ADR病例的上报（P〈0.05）。结论 PDCA循环管理法有利于我院ADR监测工作的管理,管理质量和管理水平都得到了持续改进,促进拉临床用药的安全性和合理性。
Objective To explore the effect of PDCA cycle management tool which continuously improves on the adverse drug reaction （ADR） report and surveillance and management of our hospital,the ADR reporting and the monitoring management standardizes,improving the quality of management,promoting the clinical rational administration.Methods Tapplication PDCA the problems existing in ADR surveillance of our hospital are analyzed and the reasons were found out by applying the 4 key steps in the PDCA cycle management （planning,implementation,inspection,and processing）, The plan which was aimed at addressing the problem was formulated and implemented.Problems will be discovered dur- ing the repeated check process,and the management will be improved and enhanced to achieve the purpose of stan- dardized management.Results After implementing PDCA cycle management,through establishing drug bad reaction monitoring and report work management system,taking effective measures,and implementing ADR report and monitoring, in 2015 the ADR reported total,and medical personnel reported volume,and records electronic medical record number, and reported department had respectively increased 558.0%,33.3%,and 1288.0%,and 200.0% in our hospital,effective intervention （P〈0.05）;the first medication easily occur ADR,the above reported constitute-proportion had increased 116.4%,and 320.7%% in 1-3 days and 4-10 days,effective intervention（P〈0.05）;vein and oral medicine still far above other drug way,but lead to ADR proportion had declined 16.3%,effective intervention （P〈0.05）;anti-infection material lead to the ADR proportion had declined 63.6%,effective intervention（P〈0.05）;Chinese medicine injection agent cause that ADR proportion has increased 70.3%,there was no significant difference （P〉0.05）;the damage of skin and the an- nex organ was still the most,but cause that ADR proportion had declined 18.7%,there was no significant difference （P〉 0.05）,and had increased the report of liver,gall and gastrointestin
出处
《中国当代医药》
2016年第31期139-142,共4页
China Modern Medicine
