运用MTP模式干预儿科门诊和急诊科过度输液Application of MTP Method in Controlling Excessive Intravenous Infusion in Pediatric Outpatient and Emergency Department
李伟煊,雷露雯,曾朝晖,杨凤娉,陈振华,李鹏翀
LI Weixuan,LEI Luwen,ZENG Chaohui,YANG Fengping,CHEN Zhenhua,LI Pengchong
摘要(Abstract):
目的探讨MTP(监测-培训-计划)模式对儿科门诊、急诊科过度输液的干预效果。方法抽取医院儿科门诊、急诊科2013-07~09的处方作为基线调研,分析门诊输液存在的问题,针对存在的问题通过MTP模式进行干预,比较干预前后静脉输液情况的变化。结果经过4轮MTP干预后,儿科门诊、急诊科静脉输液率分别从干预前的55.3%、74.0%下降到29.5%、51.0%;人均用药品种数分别从3.56种、3.75种下降至2.62种、3.66种;人均总费用分别从干预前的72.29元、156.36元下降到56.08元、139.69元;人均药品费用从干预前的52.93元、89.12元下降到47.72元、87.95元;抗菌药物使用率从干预前的81.1%、40.7%下降到75.8%、40.5%;抗菌药物输液率从干预前的38.1%、27.0%下降到20.2%、26.0%。结论 MTP干预模式能有效减少儿科门诊、急诊科静脉输液的过度使用。
OBJECTIVE To investigate the effect of Monitoring-Training-Planning( MTP) method on controlling excessive infusion in pediatric outpatient and emergency department. METHODS The baseline survey based on the prescription of pediatric outpatient and emergency department from July 2013 to September 2013. The problems existed in the outpatient infusion were analyzed,the change was compared after MTP intervention. RESULTS The rate of intravenous infusion of pediatric outpatient and emergency department declined from 55. 3%,74. 0% to 29. 5%,51. 0%,and the number of drug use per capita decreased from 3. 56 species,3.75 species to 2. 62 species,3. 66 species,respectively. Compared with no intervention,the total cost per patient of pediatric outpatient and emergency department decreased from 72. 29 yuan,156. 36 yuan to 56. 08 yuan,139. 69 yuan,the cost of drug use per patient decreased from 52. 93 yuan,89. 12 yuan to 47. 72 yuan,87. 95 yuan,respectively. And the usage rate of antibacterial agents dropped from 81. 1%,40. 7% to 75. 8%,40. 5%,the percentage of antibacterial agents infusion reduced from 38. 1%,27. 0% to 20. 2%,26. 0%,respectively after 4 rounds of MTP intervention. CONCLUSION The MTP method is effective in controlling excessive intravenous infusion in pediatric outpatient and emergency department.
关键词(KeyWords):
监测-培训-计划(MTP);静脉输液;干预;门诊
Monitoring-Training-Planning;intravenous infusion;intervention;outpatient
基金项目(Foundation): 佛山市医学类科技攻关项目(2014AB00592)
作者(Author):
李伟煊,雷露雯,曾朝晖,杨凤娉,陈振华,李鹏翀
LI Weixuan,LEI Luwen,ZENG Chaohui,YANG Fengping,CHEN Zhenhua,LI Pengchong
参考文献(References):
- [1]刘新春,高海青.静脉药物配置中心与静脉药物治疗[M].北京:人民卫生出版社,2006.
- [2]http://www.china.com.cn/news/2010-12/24/content_21609895.htm.
- [3]陈卫果,孙银香,蔡越秀,等.采用监测-培训-计划循环模式干预不合理用药的探索[J].中国药学杂志,2009(20):1594.
- [4]黎小妍,宋伟峰,张平,等.“监测-培训-计划”干预模式在血管介入手术围术期中的应用[J].中国药房,2012,23(30):2816-2818.
- [5]范峥,刘洋,王宏蕾,等.某院1484例药物不良反应报告分析[J].中国医院药学杂志,2014(20):1776-1779.
- [6]罗崇彬,李丽萍,方健,等.202例静脉给药不良反应报告分析[J].今日药学,2014(05):370.
- [7]袁进,石磊,廖妙玲.医院门诊输液室抗菌药物针剂使用现状调查[J].中华医院感染学杂志,2011(5):955-957.
- [8]Waitt C,Waitt P,Pirmohamed M.Intravenous therapy[J].Postgrad Med J,2004,80(939):1.