PDCA循环管理干预儿科辅助用药磷酸肌酸钠的临床效果评价
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摘要
目的探讨PDCA循环管理规范儿科辅助用药磷酸肌酸钠的临床使用,促进辅助用药的合理应用。方法采用回顾性分析方法,通过医院信息系统选取儿科使用磷酸肌酸钠的病历1 300份,其中2015年1月—2016年7月期间700份为PDCA循环干预前组,2016年9月—2017年2月期间300例病历为第1轮干预组,2017年3月—9月期间300例病历为第2轮干预组,对比分析持续干预前后磷酸肌酸钠的用药情况。结果实施2轮PDCA循环管理干预后,儿科磷酸肌酸钠使用显著减少,用药频度由736(干预前)降至193(干预后),且用药合理率明显提高,从干预前66.86%提高至第2轮干预后的93.00%。结论 PDCA循环管理法在规范儿科辅助用药磷酸肌酸钠的临床合理使用中持续改进的效果显著。
OBJECTIVE The application of PDCA cycle in rationalizing the clinical use of creatine phosphate sodium in pediatric department was explored to promote the rational use of adjuvant drug in the clinic. METHODS In retrospective analysis, 1 300 medical records of pediatric department involving creatine phosphate sodium were selected with HIS(Hospital information system), including 700 medical records from January, 2015 to July, 2016 before PDCA cycle management, 300 records from September, 2016 to February, 2017 after the first PDCA cycle management and 300 records from March to September, 2017 after the second PDCA cycle management. The use of creatine phosphate sodium was analyzed comparatively before and after PDCA cycle intervention. RESULTS After 2 cycles of PDCA cycle management intervention, the monthly DDDs value of creatine phosphate sodium in pediatric department was significantly decreased from 763 before PDCA cycle intervention to 193 after two PDCA cycles, and the rational rate of creatine phosphate sodium was significantly improved from 66.86% before intervention to 93.00% after two PDCA cycles. CONCLUSIONS PDCA cycle management could significantly promote continuous improvement for the clinical use of creatine phosphate sodium in pediatric department.
OBJECTIVE The application of PDCA cycle in rationalizing the clinical use of creatine phosphate sodium in pediatric department was explored to promote the rational use of adjuvant drug in the clinic. METHODS In retrospective analysis, 1 300 medical records of pediatric department involving creatine phosphate sodium were selected with HIS(Hospital information system), including 700 medical records from January, 2015 to July, 2016 before PDCA cycle management, 300 records from September, 2016 to February, 2017 after the first PDCA cycle management and 300 records from March to September, 2017 after the second PDCA cycle management. The use of creatine phosphate sodium was analyzed comparatively before and after PDCA cycle intervention. RESULTS After 2 cycles of PDCA cycle management intervention, the monthly DDDs value of creatine phosphate sodium in pediatric department was significantly decreased from 763 before PDCA cycle intervention to 193 after two PDCA cycles, and the rational rate of creatine phosphate sodium was significantly improved from 66.86% before intervention to 93.00% after two PDCA cycles. CONCLUSIONS PDCA cycle management could significantly promote continuous improvement for the clinical use of creatine phosphate sodium in pediatric department.
引文
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[14]LUCAS G F.Role of the phosphocreatine system on energetic homeostasis in skeletal and cardiac muscles[J].Einstein,2014,12(1):126.
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[17]CHEN Y H,ZHANG Y P,TAO P H,et al.Efficiency of three kinds of myocardial injury markers in AMI diagnosis[J].Int JLab Med(国际检验医学杂志),2007,28(4):334-336.
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[2]ZHENG X W,TAO G,DING H Y,et al.Effect of PDCAcycle in improving the rationality of opioid drugs use in cancer pain patients[J].Chin J Mod Appl Pharm(中国现代应用药学),2018,35(6):930-932.
[3]LIU Y,DU J,FENG M M,et al.Application of PDCA cycle in clinical pharmacy[J].Pract Pharm Clin Remed(实用药物与临床),2016,19(11):1442-1445.
[4]LI Z K,QU M H,WANG C J,et al.Rationality analysis of using creatine phosphate sodium in 300 cases of children[J].JPediatric Pharm(儿科药学杂志),2015,21(9):41-43.
[5]张佐慧,刘晨.200例患儿应用磷酸肌酸钠的合理性分析[J].医药导报,2016,35(s1):122-123.
[6]LIN W L,CHEN Y,YANG J H,et al.Special evaluation of adjuvant drug creatine phosphate sodium in children[J].Chin Hosp Pharmaceut J(中国医院药学杂志),2017,37(5):478-481.
[7]Editorial Committee of CNFC.Chinese National Formulary(Chemicals and Biological Products for Children)[M].1st ed.Beijing:People’s Military Medical Press,2013.
[8]王永洁.磷酸肌酸钠治疗小儿心肌炎的临床疗效观察[J].中国现代药物应用,2016,10(17):159-160.
[9]ZHU J,PAN H L,CHEN H,et al.Myocardial protective effect of exogenous creatine phosphate on operation of congenital heart disease in children[J].Chin J General Pract(中华全科医学志),2015,13(4):576-578.
[10]XIAO J Q,CAI M.Clinical research on treatment of neonates with severe pneumonia complicated with heart failure by nCPAP and creatine phosphate sodium[J].J Pediatric Pharmacy(儿科药学杂志),2012,18(9):23-25.
[11]BALESTRINO M,SAROCCHI M,ADRIANO E,et al.Potential of creatine or phosphocreatine supplementation in cerebrovascular disease and in ischemic heart disease[J].Amino Acids,2016,48(8):1-13.
[12]刘圣,傅先明.静脉用药物调配技术[M].合肥:安徽科学技术出版社,2015:419-420.
[13]STRUMIA E,PELLICCIA F,D'AMBROSIO G.Creatine phosphate:pharmacological and clinical perspectives[J].Advances in Therapy,2012,29(2):99-123.
[14]LUCAS G F.Role of the phosphocreatine system on energetic homeostasis in skeletal and cardiac muscles[J].Einstein,2014,12(1):126.
[15]BEAL M F.Neuroprotective effects of creatine[J].Amino Acids,2011,40(5):1305-1313.
[16]HAO L.Effect of creatine phosphate sodium on hypoxic ischemic myocardial damage in premature infants[J].World Latest Med Inf(世界最新医学信息文摘),2017,17(69):1-2.
[17]CHEN Y H,ZHANG Y P,TAO P H,et al.Efficiency of three kinds of myocardial injury markers in AMI diagnosis[J].Int JLab Med(国际检验医学杂志),2007,28(4):334-336.
[18]ZHANG W,YANG K,LIAO K L,et al.Significance of cardiac troponin in evaluating myocardical injury[J].Chin JClin Rehabilitation(中国组织工程研究),2004,8(33):7412-7413.
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