中国临床药学杂志

目的探讨PDCA(计划-执行-检查-处理)循环在住院癌痛患者第三阶梯镇痛药物使用管理中的作用。方法运用PDCA循环对第三阶梯镇痛药物在住院癌痛患者中的使用进行干预,比较干预前与干预后第1周期、第2周期住院患者第三阶梯镇痛药物的使用不合理情况。结果经过2个周期的干预,住院癌痛患者第三阶梯镇痛药物的使用不合理率从15.83%降低到5.84%,其中非癌痛规范化治疗(GPM)示范病房的不合理率从42.86%降低到15.46%,不合理用药类型中用药有禁忌证的比例从5.41%降低到0.39%,爆发痛处理不规范的比例从4.63%降低到1.56%,差异均具有统计学意义。结论 PDCA循环有效降低了住院癌痛患者第三阶梯镇痛药物的使用不合理率,可在癌痛治疗药物管理中推广。

AIM To investigate the effect of PDCA(plan-do-check-act) cycle in the management of the third-step analgesics for cancer pain inpatients. METHODS PDCA cycle was applied to intervene the use of third-step analgesics in cancer pain inpatients, and the irrational use of the third-step analgesics in cancer pain inpatients before and after the first and the second PDCA cycles was compared. RESULTS After two cycles of intervention, the irrational use rate of the third-step analgesics for cancer pain inpatients decreased from15.83% to 5.84%.The irrational use rate of non-GPM(good pain management) wards decreased from 42.86% to 15.46%. Among the types of irrational use, the irrational use rate of contraindications decreased from 5.41% to 0.39%, and the irrational use rate of breakthrough pain treatment decreased from 4.63% to 1.56%. All the data were statistically significant. CONCLUSION PDCA cycle can effectively reduce the irrational use rate of the third-step analgesics for cancer pain inpatients, and can be popularized in the management of cancer pain drugs.