我院应用PDCA循环管理方法规范儿童合理使用利巴韦林的实践
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篇名: 我院应用PDCA循环管理方法规范儿童合理使用利巴韦林的实践
TITLE:
摘要: 目的:评价PDCA循环管理方法在规范儿童合理用药中的效果,探讨利巴韦林用于儿童的有效性和安全性。方法:临床药师采用4次PDCA循环管理方法对利巴韦林在儿科门诊的使用进行持续性干预,并查阅权威指南和循证证据,制订了我院《儿科门诊抗病毒治疗方案简表》,为临床提供儿童常见感染性疾病的抗病毒治疗方案;通过比较采用PDCA循环管理前、后(分别为非干预组、干预组)利巴韦林处方的合理性,评价规范管理的效果。结果与结论:经过4次PDCA循环,利巴韦林的使用量明显下降;含利巴韦林制剂的处方比例由3.10%下降至0.80%(P<0.01);用药适应证适宜的处方比例从56.14%提高到90.30%(P<0.01),常规开具利巴韦林处方的诊断病种从26个下降到5个;用药途径适宜的处方比例从73.43%提高到93.75%;利巴韦林联用抗菌药物的处方比例从59.74%降至12.91%(P<0.01)。临床药师采用PDCA循环管理对利巴韦林儿童用药的管理有效、可行;利巴韦林用于儿童临床获益不明,毒副作用突出,不宜作为广谱的抗病毒药常规用于儿童。
ABSTRACT: OBJECTIVE: To evaluate the effects of PDCA cycle management on standardizing rational use of ribavirin in children, and to investigate the effectiveness and safety of ribavirin in children. METHODS: By adopting 4 times of PDCA cycle, clinical pharmacists conducted continuous intervention to ribavirin use in pediatric department; authoritative guideline and evidence-based evidence were reviewed; List of Antiviral Therapy Plans in Qutpatient Department of Prediatrics was formulated in our hospital, which provided antiviral therapy plan of common pediatric infectious disease. By compared the rationality of ribavirin prescription in the pre and post PDCA cycle management (intervention group and non-intervention group) to evaluate the effects of standard management. RESULTS & CONCLUSIONS: After 4 times of PDCA cycle, the consumption amount of ribavirin both reduced significantly. The proportion of ribavirin prescriptions decreased from 3.10% to 0.80% (P<0.01); the proportion of suitable medication indication prescriptions increased from 56.14% to 90.30% (P<0.01); diagnosed disease types of commonly prescribed ribavirin prescriptions decreased from 26 to 5; the proportion of suitable administration route prescriptions increased from 73.43% to 93.75%. The proportion of ribavirin combined with antibiotics prescriptions decreased from 59.74% to 12.91% (P<0.01). PDCA is an effective and feasible method for pediatric medication management by clinical pharmascits. Ribavirin is not recommended as routine antiviral drug for children due to its unclear clinical benefit and distinct toxicity.
期刊: 2018年第29卷第11期
作者: 王柯静,陈琳
AUTHORS: WANG Kejing,CHEN Lin
关键字: 利巴韦林;儿童用药;临床药师;PDCA循环管理;应用效果;实践
KEYWORDS: Ribavirin; Drug use in children; Clinical pharmacist; PDCA cycle management; Application effect; Practice
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