品管圈活动对减少PIVAS漏审不合理医嘱的应用及其有效性分析

目的:探究品管圈活动(QCC)对减少静脉用药调配中心(PIVAS)漏审不合理医嘱的应用及其效果。方法:抽取2017年1月-2018年1月期间医院PIVAS 3000份医嘱为管理前组,另抽取2018年2月-2019年2月期间开展品管圈活动后3000份医嘱为管理后组,对其中的不合理医嘱发生原因进行分析;比较两组医嘱中不合理医嘱发生的原因及其发生率差异;以及比较两组医嘱中QCC开展前后PIVAS工作人员的个人能力评分值的差异。结果:管理前组3000份医嘱中,其中563份医嘱存在不合理用药,其类型为给药频次不合理、溶媒选择不合理、给药剂量不合理、给药浓度不合理等,其不合理发生率为18.77%;管理后组3000份医嘱中,仅有67份医嘱存在不合理用药,不合理医嘱的发生率明显下降,其发生率仅为2.23%;管理后组显著低于管理前组(P<0.05);管理后组PIVAS工作人员的责任心、沟通能力、创造能力、积极性和团队精神的评分值均高于管理前组(P<0.05)。结论:QCC对减少PIVAS漏审不合理医嘱发挥着重要的作用,提高患者的用药安全性,充分发挥了PIVAS工作人员的团队责任性和工作能力。

Analysis on Use and ITs Effectiveness of Quality Control Circle Activities in Reducing PIVAS Missed Unreasonable Medical Orders

Objective:To explore the application and its effectiveness of quality control circle activity(QCC)in reducing the occurrence of unreasonable doctor’s orders missed in Pharmacy Intravenous Admixture Services(PIVAS).Methods:From January 2017 to January 2018,3000 medical orders of hospital PIVAS were selected as the pre-management group,and other 3000 medical orders were selected as the post-management group after the QCC were carried out from February 2018 to February 2019,the causes of unreasonable medical orders were analyzed.The differences of the causes and incidence of unreasonable medical orders were compared between the two groups.And the difference of personal ability score of PIVAS staff before and after QCC was carried out in the two groups were compared.Results:Among the 3000 medical orders in the pre-management group,563 of them contained unreasonable drug use,including unreasonable frequency of drug administration,unreasonable choice of solvent,unreasonable dosage,unreasonable concentration,etc.,with an unreasonable incidence of 18.77%.Among the 3000 medical orders in the post-management group,only 67 of them had unreasonable drug use,and the incidence of unreasonable medical orders decreased significantly,with the incidence of only 2.23%.The post-management group was significantly lower than the pre-management group(P<0.05).The scores of responsibility,communication ability,creativity,enthusiasm and team spirit of PIVAS staff in the post-management group were all higher than those in the pre-management group(P<0.05).Conclusion:QCC plays an important role in reducing the occurrence of unreasonable medical orders in PIVAS missed,improving the drug safety of patients,and giving full play to the team responsibility and working ability of PIVAS staff.