Objective: To explore the eff ect of PDCA circulation management on reducing the use rate, intensity of use and combination of antibiotics in inpatients, and to provide reference for the rational use of antibiotics in clinical practice. Methods: PDCA circulation method was used to intervene the use of antibiotics in patients of endocrinology department. Using the hospital’s HIS information system, we retrospectively sampled the antibiotic use rate, the intensity of antimicrobial use, the proportion of the number of combined use of antimicrobial drugs, the average course of antibacterial drug use of the inpatients in the Department of Endocrinology, the Second Affiliated Hospital of Shaoyang University (2019 to 2021), etc. After the intervention and tracking of clinical pharmacists, the results of antimicrobial drug use data were compared. Results: After the PDCA cycle management, the antimicrobial use rate of inpatients in the endocrine department decreased from 41.17% before implementation (2019) to 39.17% after intervention (2021). The use intensity decreased from 43.76 DDDs before implementation to 32.07 DDDs after the intervention. The proportion of the combined use of antibacterial drugs decreased from 41.97% before intervention to 24.73% after intervention. The number of days per person using antibiotics decreased from 21.17 days before implementation to 17.17 days after intervention. The above data before and after intervention were statistically significant (P＜0.05). Conclusion: The application of PDCA circulation method to control the drug use of antibiotics in patients can reduce the use rate and intensity of antibiotics, the combination of antibiotics and the course of treatment. The intervention of PDCA cycle is conducive to the rational use of antimicrobials.
Zeng Yan, Yan Yujie, Tan Huilong, Jiang Wenyan, Xiong Juliang, Zhong Shaowen, Li Mingjuan
. The Rational Use and Management of Clinical Pharmacists Using the PDCA Cycle Method for Antibacterial Drugs in Endocrinology Patients[J]. Chinese Pharmaceutical Affairs, 2023
, 37(5)
: 588
-595
.
DOI: 10.16153/j.1002-7777.2023.05.013
[1] 王云娜,何永坚,黄宇,等.PDCA循环管理的运用对降低住院患者抗菌药物使用强度的影响以及不合理用药原因的分析[J].抗感染药学,2021,18(6):853-855.
[2] 邱琼,张文悦,王宝敏,等.PDCA循环在全国基本药物质量监管工作监测调查中的应用[J].中国药事,2013,27(5):453-456.
[3] 国家卫生健康委员会办公厅,国家中医药管理局办公室,中央军委后勤保障部办公厅.医疗机构处方审核规范(国卫办医发〔2018〕14 号)[S].2018.
[4] 中华人民共和国药品管理法(2019 年国家主席令第31号)[S].2019.
[5] 抗菌药物临床应用指导原则(2)——抗菌药物临床应用的管理[J].中国临床医生,2005(6):18-19.
[6] 阚全程.PDCA 循环在医院战略管理中的运用[J].中国医院管理,2009,29(8):47-49.
[7] 史大琼.PDCA循环法在病区备用药管理中的应用[J].中国社区医师,2017,33(30):9-10,12.
[8] 肖晓,何艳,吴广杰,等.应用PDCA法践行临床药师主导的抗菌药物联合用药管理[J/OL].医药导报.https://kns.cnki.net/kcms/detail/42.1293.R.20210929.1708.002.html.
[9] 肖晓,林璐,陈志江,等.临床药师应用PDCA循环法在内分泌科住院医嘱审核干预中的实践[J].今日药学,doi:10.12048/j.issn.1674-229X.2020.09.012.
[10] 钱华,王佳良.PDCA循环管理法在药剂科药品管理中的应用[J].中医药管理杂志,2019,27(19):118-119.
[11] 朱晓美,孙德春,赵芳,等.PDCA循环在我院抗菌药物临床应用专项整治活动中的作用[J].中国药房,2016,27(2):166-168.
[12] 刘玲,李春梅,杨晓丽,等.PDCA 循环在提高医院感染管理质量中的效果分析[J].中华医院感染学杂志,2017,27(3):685-687.
[13] 刘世坤.湖南省处方审核实施细则[J].中南药学,2020,17(6):801-805.
[14] 中华人民共和国卫生部.医院处方点评管理规范(试行)(卫医管发〔2010〕28 号)[S].2010.
[15] Xiao Y,Shen P,Zheng B,et al.Change in AntibioticUse in Secondary and Tertiary Hospitals Nationwide aftera National Antimicrobial Stewardship Campaign wasLaunched in China,2011-2016:An ObservationalStudy[J].J Infect Dis,2020(Suppl2):S148-S155.
[16] 潘姝,原永芳,金剑.临床药师参与心血管内科临床治疗实践的回顾性研究及思路探讨[J].中国现代应用药学,2019,36(10):1260-1263.
[17] Zhao H,Wei L,Li H,et al.Appropriateness of AntibioticPrescriptions in Ambulatory Care in China:A NationwideDescriptive Database Study[J].Lancet Infect Dis,2021,21(6):847-857.
[18] 傅昌芳,陈昭琳,沈爱宗.临床药师实施医嘱审核对不合理医嘱干预效果分析[J].中南药学,2018,16(10):1446-1449.
[19] LI H,YAN S,LI D,et al.Trends and Patterns ofOutpatient and Inpatient Antibiotic Use in China'sHospitals:Data from the Center for AntibacterialSurveillance,2012-16[J].J Antimicrob Chemother,2019,74(6):6-12.
[20] 曹媛,邓蓉蓉,孙萍萍.临床药师参与辅助用药的医嘱审核及干预的效果分析[J].今日药学,2017,27(4):271-273.
[21] 张伶俐,张扬,曾力楠,等.美国临床药师的工作职责及定位[J].中国药房,2016,27(34):4753-4756.
[22] 钟洪兰,李艳.抗菌药物使用强度控制的原则和六项技术干预策略[J].现代医院,2019,7(19):959-960.
[23] 喻玮,肖永红.正确认识联合用药治疗耐药菌感染[J].医药导报,2019,38(7):835-842.
[24] 《中国药物与临床》——关注药学前沿,指导服务临床[J].山西医药杂志,2022,51(3):240.
[25] 胡展红,邱晓燕.肾内科临床药师开展医嘱审核的思维模式初探[J].中国药房,2017,28(20):2862-2864.
