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目的:提高小袋包装中药配方颗粒的调剂质量,降低调剂差错率、缩短摆药时间。方法:对我院中药房小袋包装中药配方颗粒的调剂,从“人、机、环、法、物”5个方面找出关键影响因素进行两轮PDCA循环管理干预。比较PDCA循环管理干预前(2015年7-12月,A组)、第1轮PDCA循环管理干预组(2016年1-6月,B组)、第2轮PDCA循环管理干预组(2016年7-12月,C组)3个阶段的调剂内差、摆药时间,评价管理效果。结果:通过改善调剂环境、建立调剂标准操作规程、制订奖惩制度、人员培训等整改措施,经过两轮PDCA 循环管理干预后,我院中药房小袋包装中药配方颗粒的调剂差错率由干预前A组的4.19%(170/4 061)下降至干预后B、C组的1.69%(85/5 043)、0.98%(53/5 408)(P<0.05或P<0.01),剂数为7剂的处方平均摆药时间由干预前A组的(9.08±2.56) min缩短至干预后B、C组的(7.37±1.98)、(5.97±1.64) min(P<0.05)。结论:我院实施的PDCA循环管理干预可降低小袋包装中药配方颗粒的调剂差错率、缩短摆药时间。
OBJECTIVE: To improve dispensing quality of small package of TCM formula granule, reduce the rate of dispensing error and shorten dispensing time. METHODS: Key influential factors for small package of TCM formula granule dispensing in our hospital were found out from 5 respects of “man, machine, environment, method, material”; two cycles of PDCA cycle management intervention were conducted. Dispensing internal error and dispensing time were compared before PDCA cycle management intervention (Jul.-Dec. 2015, group A), first cycle of PDCA cycle management intervention (Jan.-Jun. 2016, group B) and second cycle of PDCA cycle management intervention (Jul.-Dec. 2016, group C), the effects of management were evaluated. RESULTS: By improving dispensing environment, establishing dispensing standard operation procedure, formulating reward and punishment system, staff training, after 2 cycles of PDCA cycle management intervention, the rate of small package of TCM formula granule dispensing error in TCM pharmacy of our hospital decreased from 4.19% (170/4 061) before intervention that of group A to 1.69% (85/5 043) and 0.98% (53/5 408) in group B and C after intervention (P<0.05 or P<0.01). Average dispensing time of each prescription with 7 doses were shortened from (9.08±2.56) min before intervention (group A) to (7.37±1.98), (5.97±1.64) min in group B and C after intervention (P<0.05). CONCLUSIONS: PDCA cycle management intervention in our hospital can reduce the rate of small package of TCM formula granule dispensing error and shorten dispensing time.
PDCA循环管理小袋包装中药配方颗粒调剂差错摆药时间干预效果
PDCA cycle managementSmall packageTCM formula granuleDispensing errorDispensing timeIntervention effect
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