精细化管理法减少中药注射剂不合理配伍的效果分析

Effect of Fine Management on Reducing Irrational Compatibility of Traditional Chinese Medicine Injection

马娟娟 ¹高旭 ¹范顺心 ¹陈品英 ¹田虹利 ¹程杰¹

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作者信息

1. 河北省中医院药学部,河北省中药制剂产业技术研究院,石家庄 050000
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摘要

目的:评价精细化管理法减少中药注射剂不合理配伍的效果.方法:通过鱼骨图分析可能影响中药注射剂不合理配伍的因素,针对关键问题实施精细化管理,调查精细化管理干预前(2021 年 7-12 月)、干预后(2022 年 7-12 月)该院中药注射剂医嘱,对不合理配伍医嘱进行统计分析,对比干预前后中药注射剂医嘱配伍不合理率,探讨干预措施的有效性.结果:干预前,25 453 组中药注射剂医嘱中,不合理配伍医嘱 2 366 组,中药注射剂医嘱配伍不合理率为 9.30%;干预后,28 466 组中药注射剂医嘱中,不合理配伍医嘱 855 组,中药注射剂医嘱配伍不合理率为 3.00%,不合理率较干预前降低 67.74%.干预后,中药注射剂医嘱中溶剂剂量不适宜、违反"十九畏"原则和溶剂种类选择不当问题大幅减少,未冲管和中西药混合输注问题已基本不存在.表明精细化管理模式能够有效改善中药注射剂医嘱不合理配伍情况.结论:通过鱼骨图分析可能影响中药注射剂不合理配伍的因素,针对关键问题实施精细化管理,可有效减少中药注射剂的不合理配伍现象,为其他医院中药注射剂的合理应用提供了参考.

Abstract

OBJECTIVE:To evaluate the effect of fine management on reducing irrational compatibility of traditional Chinese medicine(TCM)injection.METHODS:Fishbone diagram was used to analyze the factors that may affect the irrational compatibility of TCM injection,and the refined management was implemented for key problems.Medical orders of TCM injection before the intervention of refined management(from Jul.to Dec.2021)and after the intervention(from Jul.to Dec.2022)were investigated.The irrational compatibility medical orders were statistically analyzed.Incompatibility rate of TCM injection in medical orders were compared before and after intervention and the effectiveness of intervention measures were investigated.RESULTS:Before intervention,among 25 453 groups of medical orders with TCM injection,2 366 groups were inappropriately matched,and the incompatibility rate was 9.30%.After intervention,among 28 466 groups of medical orders with TCM injection,855 groups had irrational compatibility of TCM injection,and the irrational compatibility rate was 3.00%,which was 67.74%lower than that before intervention.After intervention,the problems of inappropriate solvent dosage,violation of"Nineteen Medicaments of Mutual Restraint"and improper selection of solvent types in TCM injection decreased greatly,and the problems of unflushed tube and mixed infusion of Chinese and Western medicines were eliminated.The results showed that the fine management model could effectively improve the irrational compatibility of TCM injection in medical orders.CONCLUSIONS:By analyzing the factors that may affect the irrational compatibility of TCM injection through fishbone diagram and implementing fine management for the key problems,the irrational compatibility of TCM injection can be effectively reduced,which provides reference for the rational application of TCM injection in other hospitals.

关键词

中药注射剂/鱼骨图分析法/精细化管理法/配伍/合理用药

Key words

Traditional Chinese medicine injection/Fishbone diagram analysis/Fine management method/Compatibility/Rational drug use

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基金项目

河北省中医药局科研项目(2020005)

出版年

2024

中国医院用药评价与分析

中国医药生物技术协会，中国药房杂志社

中国医院用药评价与分析

CSTPCD

影响因子：1.142

ISSN：1672-2124

参考文献量20

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