信息化门诊药学服务质控体系的建立与实践效果考察
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摘要
目的建立信息化门诊药学服务质控体系,并考察其实践效果,探索优化与推广思路。方法自2017年1月起,于江苏省常州市第二人民医院(以下简称"我院")推行涵盖处方审核、药品调剂、用药管理的信息化门诊药学服务质控体系,比较该质控体系实施前(2016年1～12月)、实施后(2017年1～12月)门诊处方合格率、药品调剂工作差错率及患者药占比、满意度变化,考察信息化门诊药学服务质控体系的实践效果,总结应用体会。结果我院2017年总处方数量较2016年增加,但不合格处方占比明显下降(P <0.05),药品调剂工作差错率较2016年明显下降(P <0.05)。2016年我院药占比、患者满意度分别为46.08%、82.44%,2017年我院药占比、患者满意度分别为42.15%、95.33%,信息化门诊药学服务质控体系实施后,我院药占比下降8.53%,患者满意度上升15.64%,实施前后的药占比、满意度差异均有统计学意义(P <0.05)。结论信息化门诊药学服务质控体系的建立能够有效减少不合格处方、药品调剂工作差错,对于合理分配医疗资源、提高医疗质量也有着积极意义。
Objective To establish a quality control system for information outpatient pharmacy service, and to investigate its practice effect and explore the way to optimization and promotion. Methods Since January 2017, the quality control system of information outpatient pharmacy service has been carried out in Changzhou Second People′s Hospital of Jiangsu Province("our hospital" for short), which included prescription audit, drug dispensing and drug administration. The rate of outpatient prescription, the error rate of drug dispensing work, the changes of patient′s drug proportion and satisfaction were compared before(from January to December 2016) and after(from January to December 2017) the implementation of the quality control system. The practical effect of the quality control system of information outpatient pharmacy service was investigated, and the application experience was summarized. Results In our hopsital, the total number of prescriptions increased in 2017 compared with 2016, but the proportion of unqualified prescriptions decreased significantly(P < 0.05). The error rate of drug dispensing decreased significantly in 2016(P < 0.05). In 2016,the proportion of drugs and patients′ satisfaction in our hospital was 46.08% and 82.44%, respectively. In 2017, the proportion of drugs and patients′ satisfaction in our hospital was 42.15% and 95.33%, respectively. After the implementation of the quality control system of pharmaceutical care in informationized outpatient clinics, the proportion of drugs in our hospital decreased by 8.53%, and the satisfaction of patients increased by 15.64%, there were statistically significant differences of the proportion of drugs and patients′ satisfaction before and after implementation(P < 0.05).Conclusion The establishment of quality control system for information outpatient pharmacy service can effectively reduce unqualified prescriptions and drug dispensing errors, which is of positive significance for rational allocation of medical resources and improvement of medical quality.
Objective To establish a quality control system for information outpatient pharmacy service, and to investigate its practice effect and explore the way to optimization and promotion. Methods Since January 2017, the quality control system of information outpatient pharmacy service has been carried out in Changzhou Second People′s Hospital of Jiangsu Province("our hospital" for short), which included prescription audit, drug dispensing and drug administration. The rate of outpatient prescription, the error rate of drug dispensing work, the changes of patient′s drug proportion and satisfaction were compared before(from January to December 2016) and after(from January to December 2017) the implementation of the quality control system. The practical effect of the quality control system of information outpatient pharmacy service was investigated, and the application experience was summarized. Results In our hopsital, the total number of prescriptions increased in 2017 compared with 2016, but the proportion of unqualified prescriptions decreased significantly(P < 0.05). The error rate of drug dispensing decreased significantly in 2016(P < 0.05). In 2016,the proportion of drugs and patients′ satisfaction in our hospital was 46.08% and 82.44%, respectively. In 2017, the proportion of drugs and patients′ satisfaction in our hospital was 42.15% and 95.33%, respectively. After the implementation of the quality control system of pharmaceutical care in informationized outpatient clinics, the proportion of drugs in our hospital decreased by 8.53%, and the satisfaction of patients increased by 15.64%, there were statistically significant differences of the proportion of drugs and patients′ satisfaction before and after implementation(P < 0.05).Conclusion The establishment of quality control system for information outpatient pharmacy service can effectively reduce unqualified prescriptions and drug dispensing errors, which is of positive significance for rational allocation of medical resources and improvement of medical quality.
引文
[1]陈云,邹宜諠,邵蓉,等.美国、英国、澳大利亚社区药师职责扩展的实践及对我国的启示[J].中国药房,2017,28(34):4758-4762.
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[11]桂彦,李刚,李先飞,等.我院药师依托微信公众平台开展药学服务的实践与体会[J].中国药房,2015,26(35):5015-5016.
[12]沈佳,金润麟.基于信息化自动化技术,提高医院病区药房高危药品的管理[J].药学服务与研究,2015,15(3):234-236.
[13]任佳伟,陈红艳.改进医院信息化管理系统防范门诊药房调剂差错的探索[J].中国基层医药,2017,24(12):1908-1911.
[14]吴静,郑造乾,方国英,等.基于信息化的处方点评综合用药管理系统的实践探索[J].中国现代医生,2017,55(20):137-141.
[15]杨文超,韩玲,李雨辰,等.某院门诊药房信息化药品调剂差错防范体系的建立与运行[J].中国医院药学杂志,2017,37(8):676-681.
[16]刘莉莉.中医院信息化发展现状分析与对策[J].西部中医药,2017,30(11):82-84.
[17]汪建龙,王建武,陈鹏.基于信息化系统的药品采购新模式[J].药学服务与研究,2015,15(3):239-240.
[18]高微微,张万里,王晓微,等.信息化技术优化门急诊输液室护理工作流程和管理[J].中国现代医生,2017,55(10):155-158.
[19] Leguelinel-Blache G,Castelli C,Roux-Marson C,et al.Impact of collaborative pharmaceutical care on inpatients′medication safety:study protocol for a stepped wedgecluster randomized trial(MEDREV study)[J]. Trials,2018,19(1):19.
[20]陈蓉,顾宝晨,姚立军,等.门诊药房自动化和信息化的建设与实践[J].药学服务与研究,2017,17(5):329-333.
[21]刘卿青,许静,王之羽,等.微信药学服务公众平台的建立与应用[J].药学服务与研究,2017,17(4):302-304.
[2]姚峥,杨军,崔晓辉,等.医药分开新形势下发挥临床药师在规范门诊用药中的作用[J].中国医院,2017,21(9):68-70.
[3]梁游天,邬蓉,朱芳芳,等.临床药师在门诊信息化全处方点评中的技术复核[J].药学服务与研究,2015,15(6):455-458.
[4] Alomi YA,Alghamdi SJ,Alattyh RA. Strategic Plan of Gen-eral Administration of Pharmaceutical Care at Ministry ofHealth in Saudi Arabia 2012-2022[J]. J Pharm PharmSci,2015,1(3):1-8.
[5] Geurts MM,Stewart RE,Brouwers JR,et al. Implicationsof a clinical medication review and a pharmaceutical careplan of polypharmacy patients with a cardiovascular disor-der[J]. Int J Clin Pharm,2016,38(4):808-815.
[6]谢贤,项耀钧,胡晋红.优化软件设计和运用远程移动互联网技术完善医学研究伦理审查信息化建设[J].药学服务与研究,2015,15(3):175-178.
[7]邵峰.医院信息化管理系统在促进合理用药中的作用[J].中国处方药,2015,13(1):23-24.
[8]国家卫生计生委,财政部,国家发展改革委,等.关于巩固破除以药补医成果持续深化公立医院综合改革的通知[Z].国卫体改发[2018]4号,2018-03-05.
[9] El Hajj MS,Al-saeed HS,Khaja M. Qatar pharmacists′understanding,attitudes,practice and perceived barriersrelated to providing pharmaceutical care[J]. Int J Clin Pharm,2016,38(2):330-343.
[10] Kimura M,Go M,Iwai M,et al. Evaluation of the role andusefulness of a pharmacist outpatient service for patientsundergoing monotherapy with oral anti-cancer agents[J].J Oncol Pharm Pract,2017,23(6):413-421.
[11]桂彦,李刚,李先飞,等.我院药师依托微信公众平台开展药学服务的实践与体会[J].中国药房,2015,26(35):5015-5016.
[12]沈佳,金润麟.基于信息化自动化技术,提高医院病区药房高危药品的管理[J].药学服务与研究,2015,15(3):234-236.
[13]任佳伟,陈红艳.改进医院信息化管理系统防范门诊药房调剂差错的探索[J].中国基层医药,2017,24(12):1908-1911.
[14]吴静,郑造乾,方国英,等.基于信息化的处方点评综合用药管理系统的实践探索[J].中国现代医生,2017,55(20):137-141.
[15]杨文超,韩玲,李雨辰,等.某院门诊药房信息化药品调剂差错防范体系的建立与运行[J].中国医院药学杂志,2017,37(8):676-681.
[16]刘莉莉.中医院信息化发展现状分析与对策[J].西部中医药,2017,30(11):82-84.
[17]汪建龙,王建武,陈鹏.基于信息化系统的药品采购新模式[J].药学服务与研究,2015,15(3):239-240.
[18]高微微,张万里,王晓微,等.信息化技术优化门急诊输液室护理工作流程和管理[J].中国现代医生,2017,55(10):155-158.
[19] Leguelinel-Blache G,Castelli C,Roux-Marson C,et al.Impact of collaborative pharmaceutical care on inpatients′medication safety:study protocol for a stepped wedgecluster randomized trial(MEDREV study)[J]. Trials,2018,19(1):19.
[20]陈蓉,顾宝晨,姚立军,等.门诊药房自动化和信息化的建设与实践[J].药学服务与研究,2017,17(5):329-333.
[21]刘卿青,许静,王之羽,等.微信药学服务公众平台的建立与应用[J].药学服务与研究,2017,17(4):302-304.