PDCA循環在婦保院藥品不良反應上報中的應用分析

孟凡成，宋和娣

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PDCA循環在婦保院藥品不良反應上報中的應用分析

孟凡成，宋和娣

[摘要]目的：探索PDCA循環在婦保院藥品不良反應(ADR)上報工作中的應用，提高ADR的上報質量。方法：應用PDCA循環進一步完善ADR監測的管理制度，將ADR監測上報工作納入臨床藥師考核體系，通過各種信息平臺傳遞ADR信息，并加強對醫務人員ADR監測和上報的培訓工作，根據婦保院專科特色，加強對重點藥品品種的ADR監測，如抗菌藥物和婦產科用藥。結果：2014年上半年(干預前)和2014年下半年(干預后)ADR上報數量從46例增至170例，新增ADR例數從11例增至45例，同時也提高了病區ADR上報率(36.9%增至57.2%)；2014年下半年婦產科用藥產生ADR比例與2014年上半年相比有所上升(23.91%vs 36.47%)，2014年下半年抗菌藥物產生ADR比例與2014年上半年相比有所下降(36.96%vs 30.58%)；2014年ADR類型以胃腸系統為主。結論：運用PDCA循環應用于藥品ADR上報工作管理，促進了ADR監測工作的發展，加強了醫務人員對ADR的監測和上報意識，同時提高了臨床藥師的工作能力。

[關鍵詞]PDCA循環；藥品不良反應；監測管理；臨床藥師

Application of PDCA cycle in monitoring and management of adverse drug reactions in maternity and child health care hospitalMENGFan-cheng，SONGHe-di。(MaternityandChildHealthCareHospitalofLianyungang,Jiangsu222006,China)

【Abstract】Objective：To explore the application of PDCA cycle in adverse drug reaction (ADR) monitoring, and to improve the reporting quality of ADR.Methods:PDCA cycle was applied to improve the ADR monitoring management system.The ADR monitoring was involved in the appraisal system of clinical pharmacists and the networking platform of ADR reporting was established.The training of physicians and nurses was strengthened to improve ADR monitoring knowledge,at the same time ADR monitoring of important drugs like antimicrobial drugs and obstetrics and gynecology medicine was also reinforced.Results:Before and after the intervention in 2014,ADR reports increased from 46 cases to 170 cases,especially the new ADR,from 11 cases to 45 cases.At the same time the proportion of inpatients' ADR reports rose significantly from 36.9% to 57.2% and the proportion of ADR drugs like antibiotics decreased (36.96% vs 30.58%) and obstetrics and gynecology medicine grew (23.91% vs 36.47%).The common types of ADR were mainly of gastrointestinal system and its appendages.Conclusion:PDCA cycle management of ADR monitoring can promote the management level,strengthen the awareness of ADR monitoring and reporting,and improve the ability of clinical pharmacists.

【Key words】PDCA cycle; Adverse drug reaction; Monitoring management; Clinical pharmacist

藥品不良反應(ADR)監測和上報可有效減少不良事件的發生，降低患者治療費用，保證臨床安全、有效、合理用藥[1]。目前醫療機構不良反應監測工作取得了很大的成就，但同時也普遍存在醫務工作者對ADR監測和上報的意識薄弱，上報數量和質量低等問題，經常有隱瞞和漏報情況出現[2]。運用PDCA循環對ADR監測工作進行管理，有助于藥品不良反應與不良事件的監測管理[3]，有效地促進臨床合理用藥，提高藥品不良反應的監測管理。……