基于SBAR沟通模式的PIVAS药师临床实践

目的： 探讨标准化沟通模式（SBAR）在静脉用药调配中心（PIVAS）药师临床实践中的应用效果。方法： 选取2019年2月-2019年6月放疗科患者330例为对照组，PIVAS药师采用传统沟通模式；选取2019年8月-2019年12月苏州大学附属第一医院放疗科患者321例为观察组，PIVAS药师采用SBAR沟通模式。对比两组模式下抗肿瘤药物临床监护结果、医生用药咨询数、药师用药干预采纳数、患者满意度。结果： 应用SBAR沟通模式进行临床实践后，抗肿瘤药物临床监护中紫杉醇脂质体预处理时机达标率由46.73%提高到76.55%，奈达铂水化达标率由48.67%提高到97.25%，联合化疗给药顺序总体达标率由71.53%提高至96.78%，稳定性总体达标率由81.91%提高至99.12%，滴注时间总体达标率由72.69%提高至88.26%；医生用药咨询数由（25±3）例/月提高至（53±4）例/月、药师用药干预采纳数由（23±5）例/月提高至（67±9）例/月；与患者沟通时，用药教育完整性由66.67%提升至93.15%、用药咨询回答准确性由53.33%提升至86.60%、不良事件记录及时性由60.00%提升至93.46%（均P<0.05）。结论： 基于SBAR沟通模式，提升了PIVAS药师在临床实践中与护士、医生、患者沟通过程的专业性及满意度，在医、药、护多学科协作的建设中体现出一定价值。

Clinical practice for PIVAS pharmacists based upon SBAR communication model

OBJECTIVE To explore the application outcomes of communication model of(situation-background-assessment-recommendation) SBAR in clinical practice of pharmacy intravenous admixture service(PIVAS) pharmacists.METHODS From February 2019 to June 2019, a total of 330 patients were selected from radiotherapy department as control group and PIVAS pharmacists applied the traditional communication model. From August 2019 to December 2019, another 321 patients from radiotherapy department, with whom PIVAS pharmacists employed the SBAR communication model, were selected as observation group. The clinical monitoring results of anti-tumor agents, the number of consulting physicians, the number of pharmacist interventions and the satisfaction of patients were compared between two groups.RESULTS After applying SBAR communication model for clinical practices, the pretreatment compliance rate of paclitaxel liposome jumped from 46.73% to 76.55% and the compliance rate of hydration for nedaplatin rose from 48.67% to 97.25%. The overall compliance rate of chemotherapy dosing sequence increased from 71.53% to 96.78%. The overall stability compliance rate spiked from 81.91% to 99.12% and the overall compliance rate of infusion time increased from 72.69% to 88.26%;The number of consulting physicians rose from(25±3) cases/month to(53±4) cases/month and the number of pharmacists’ medication intervention acceptance increased from(23±5) to(67±9) cases/month. When communicating with patients, the completeness of medication education increased from 66.67% to 93.15%. The accuracy of medication consultation answers increased from 53.33% to 86.6% and the timeliness of adverse event records rose from 60.00% to 93.46%(P<0.05).CONCLUSION Based upon the SBAR communication model, the professionalism and satisfaction of PIVAS pharmacists in communicating with nurses, physicians and patients have greatly improved in clinical practices. And it has demonstrated some value in constructing a multidisciplinary healthcare team.