摘要
目的 探索建立一种信息化药物治疗路径管理新模式.方法 通过多学科诊疗(MDT)制定骨科药物治疗路径,并借助信息系统实施路径管理,落实精细的管控规则.选取管理路径实施前(2022 年1-5 月)病例为对照组,管理路径实施后(2022 年6-12 月)病例为改进组,以评估管理效果.结果 建立 8 大类手术的药物治疗路径,在医院信息系统(HIS)维护推荐药品医嘱990 条,MINDS系统维护管控规则176 条,应用药物治疗路径管理新模式后,骨科抗菌药物使用率、抗菌药物使用强度、住院次均药费和基药金额占比等指标均有明显改善;通过对路径实施前后病例分析,骨科抗菌药物、镇痛药物、补液扩容药物、抑酸护胃药物和活血消肿中成药使用合理率分别提高21.6%、12.7%、23.3%、32.1%和27.1%,平均药费分别降低111.51、15.33、49.84、42.29和14.23元.结论 该院建立的以 MDT为基础的药物治疗路径管理模式切实可行,相关经验可为医药同行提供参考.
Abstract
Objective To explore the establishment of a new model of informational drug treatment pathway management.Methods The orthopedic drug treatment pathways was developed through multidisciplinary diagnosis and treatment(MDT),and the pathway management was implemented with the help of an information systems to implement refined control rules.Cases before the implementation of the management pathway(January to May 2022)were selected as the control group,and cases after the implementation of the management pathway(June to December 2022)were selected as the improvement group to evaluate the management effectiveness.Results After establishing drug treatment pathways for 8 major types of surgeries,maintaining 990 medical prescriptions for recommended drugs in the HIS system,and 176 control rules in the MINDS system.There was a significant improvement in the orthopaedic department's indexes of antimicrobial drug use rate,antibacterial drug use intensity,average inpatient medication cost,and percentage of the amount of basic medication after applying a new model of drug treatment pathway management.According to the case analysis before and after the implementation of the pathway,the rational rate of using orthopedic antibiotics,analgesics,fluid replacement and volume expansion drugs,acid inhibiting and stomach protecting drugs,blood activating and swelling-reducing proprietary Chinese medicines were increased by 21.6%,12.7%,23.3%,32.1% and 27.1%,respectively.The average drug costs was reduced by 111.51 yuan,15.33 yuan,49.84 yuan,42.29 yuan and 14.23 yuan,respectively.Conclusion The management mode of drug treatment pathway based on MDT established by our hospital is practical and effective,and the relevant experience may provide valuable insights for pharmaceutical peers.
维普
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