摘要
目的:为精神专科医院提高第二类精神药品合理使用水平提供参考。方法:通过引入“使用强度”管理指标、组建精益管理小组、利用信息化平台、加强人员培训考核、开展科普宣教、及时发布药学通讯等措施,构建第二类精神药品精益管理模式。通过医院信息系统收集2022年7月—2023年6月(精益管理前)和2023年7月—2024年6月(精益管理后)的住院患者第二类精神药品使用率、使用强度、医嘱点评合格率、占西药总金额比例、平均住院日等数据进行比较。结果:与精益管理前相比,精益管理后住院患者第二类精神药品使用率由78.36%降至77.23%(P=0.224),使用强度由56.77 DDDs降至46.45DDDs(P<0.001),医嘱点评合格率由90.39%上升至95.23%(P<0.001),占西药金额比例从6.52%降至5.87%(P=0.006),平均住院日从42.46 d降至38.55 d(P=0.323)。结论:通过引入“使用强度”管理指标结合精益管理方法,构建了第二类精神药品使用精益管理模式,弥补了金额排名和使用率管控的不足,提供了评价第二类精神药品合理使用的质控指标,值得在精神专科医院进行推广。
OBJECTIVETo provide references for improving rational use of ClassⅡpsychotropic drugs in psychiatric hospitals.METHODSS By introducing of usage intensity indicators,setting up lean management team,using the information platform,strengthening personnel training and assessment,carrying out science popularization and education,releasing of pharmaceutical newsletter in time,a new lean management mode of ClassⅡpsychotropic drugs was constructed in our hospital.The rate of using ClassⅠpsychotropic drugs,intensity of their usage,pass rate of medical order reviews,proportion of total amount of Western medicines,and average hospitalization day of inpatients admitted from July 2022 to June 2023(before the application of lean management mode)and those from July 2023 to June 2024(after the lean management mode)were compared.RESULTS Compared to data before the implementation lean management,the utilization rate of ClassⅡpsychotropic drugs significantly decreased from 78.36%to 77.23%(P=0.224),intensity of ClassⅡpsychotropic drugs use significantly decreased from 56.77 DDDs(defined daily doses)to 46.45 DDDs(P<0.001),the qualified rate of ClassⅡpsychotropic drugs doctor's advice significantly increased from 90.39%to 95.23%(P<0.001),the proportion of ClassⅡpsychotropic drugs in the total amount of Western medicine significantly decreased from 6.52%to 5.87%(P=0.006),and the average length of stay significantly decreased from 42.46 days to 38.55 days(P=0.323)after the implementation of lean management.CONCLUSⅠON By introducing the usage intensity indicators and lean management method to create the lean management model of ClassⅡpsychotropic drugs use,it has made up for the lack of amount ranking and utilization rate and provided quality control indicators for the rational use of ClassⅡpsychotropic drugs in our hospital.It is worth to popularize in psychiatric hospital.
作者
朱利芳
李焕芬
王领军
钱东丽
陈永新
徐亚辉
郭飞
ZHU Lifang;LI Huanfen;WANG Lingjun;QIAN Dongli;CHEN Yongxin;XU Yahui;GUO Fei(Department of Pharmacy,the Second Affiliated Hospital of Xinxiang Medical University,Henan Xinxiang 453002,China;Department of Sleep Medicine,the Second Affiliated Hospital of Xinxiang Medical University,Henan Xinxiang 453002,China)
出处
《中国医院药学杂志》
北大核心
2025年第14期1673-1677,1685,共6页
Chinese Journal of Hospital Pharmacy
基金
新乡医学院第二附属医院管理类课题(编号:2023GLLKT-Y-004)
河南省医学科技攻关计划联合共建项目(编号:LHGJ20220639)。
关键词
第二类精神药品
使用强度
精益管理
合理使用
ClassⅡpsychotropic drugs
usage intensity
lean management
rational use
