5S管理参与的药剂科综合管理模式对医院抗菌药物合理应用的效果分析

目的了解古交矿区总医院屯兰分院药剂科参与5S管理后并且使用综合管理模式下观察医院抗菌药物合理应用的情况,为后续科学、规范化管理医院提供依据。方法选择2018年5月至2019年5月在古交矿区总医院屯兰分院使用抗菌药物治疗的住院患者病历100份,随机数字表法分为对照组和观察组,观察组实施5S参与强化管理后的药剂科综合管理模式,对照组采用常规管理模式。对比2组患者在住院期间抗菌药物的使用状态,考察抗菌药物使用是否合理,考察治疗情况及管理效果。结果观察组患者抗菌药物的管理效果方面(包括人均药物费用、人均抗菌药物费用、患者平均住院时间及抗菌药物费用占比)、抗菌药物用药不合理情况(包括不合理联合用药、用药品种不当、使用剂量偏大或偏小、用药间隔时间不当、用药疗程过长、用药时机及用药途径等方面)均低于对照组,且差异有统计学意义(P<0.05);同时采用强化5S管理后的药剂科综合管理模式在药品安全评分、记录书写、减少差错事件、药品服务、工作态度等方面均显著优于实施前。结论采用5S管理后可以避免抗菌药物滥用,对规范化诊疗、提升医疗质量具有积极作用。

Effect analysis on rational application of antibiotics in hospital by comprehensive management mode of pharmacy department involving 5S management

Objective To invesitgate the rational use of antibacterials in Tunlan Division,Gujiao Mining Area General Hospital after implementation of the integrated pharmacy management model reinforced with 5S management method,so as to provide evidence for future strategies on scientific and standardized hospital man-agement.Methods One hundred medical records of patients treated with antibiotics in our hospital between May 2018 and May 2019 were randomly selected and divided into the control group and the study group.Specifically,the study group was subjected to integrated pharmacy management model reinforced with 5S management method,while the control group was subjected to conventional pharmacy management model.The two groups were record-ed and compared for antimicrobialsuse during the hospital stay.Thereby,the rationality of antimicrobial use,treat-ment efficacy and management outcomes were evaluated.Results The management outcome measures(including per capita drug cost,per capita cost of antibacterial treat-ment,mean length of hospital stay,and contribution of antimicrobial agents to total drug costs),irrational use of antibacterial drugs(including improper antibacterial com-binations,improper selection of antibacterial categories,over-dosing or under-dosing of antibacterials,improper in-tervals between antibacterial doses,excessive duration of antibacterial use,problematic timing and routes of an-tibacterial use)were less frequent in the study group compared with the control group,with statistically significant differences(P<0.05).In addition,integrated pharmacy management model reinforced with 5S management method led to significant improvements in rating of drug safety,written records,malpractice,pharmacy services,and work attitudes,compared with the pre-implemantation situations.Conclusion Enforcement of integrated pharmacy management model reinforced with 5S management method in hospital reduces antibiotics misuse,and also posi-tively contributes to standardizing diagnosis and treatment,improving the quality of medical treatment.