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目的:评价品管圈(QCC)在提高门诊哮喘/慢性阻塞性肺疾病(COPD)患者吸入装置使用依从性中的效果。方法:采用简单随机抽样方法,选取2015年4-11月于我院门诊使用噻托溴铵粉吸入剂、沙美特罗替卡松粉吸入剂和布地奈德福莫特罗粉吸入剂治疗的哮喘/COPD患者共90例,通过QCC活动分析其吸入装置使用依从性不佳的原因,拟定临床药师教育、随访、发放教育手册、开展微信公众号用药咨询服务等对策以改善其依从性,并统计活动前后患者吸入装置操作步骤评分、依从性评分和圈员的各项活动能力评分。结果:开展QCC活动后,90例门诊哮喘/COPD患者的吸入装置操作步骤评分和依从性评分分别由活动前的7.7和7.7分提高到8.8和9.3分,依从性的目标达标率为114.3%,进步率为20.8%;圈员荣誉感、责任心、自信心、QCC手法、沟通协调和团队凝聚力等活动能力均有明显提高。结论:QCC活动的开展有效提高了门诊哮喘/COPD患者吸入装置使用的依从性,体现了临床药师的专业服务水平,对于提升医院药学服务质量具有显著意义。
OBJECTIVE: To evaluate the effects of quality control circle (QCC) in improving the compliance of asthma/COPD outpatients handling inhaler devices. METHODS: By simple random sampling method, 90 asthma/COPD outpatients receiving Tiotropium bromide powder for inhalantion, Salmeterol xinafoate and fluticasone propionate powder for inhalantion and Budesonide and formoterol fumarate powder for inhalantion were selected from our hospital during Apr. to Nov. 2015. The reasons for poor compliance of handling inhaler devices were analyzed by QCC. The countermeasures were formulated to improve the compliance, including clinical pharmacist education, follow-up, issuing education manuals, developing WeChat consulting. Operation step score of inhaler devices, compliance score and activity ability score of QCC members were analyzed statistically before and after QCC. RESULTS: After the development of QCC, operation step score of inhaler devices and compliance score in 90 asthma/COPD outpatients increased from 7.7 and 7.7 before activity to 8.8 and 9.3 after activity, the achievable rate of compliance was 114.3%, and the improvement rate was 20.8%. The sense of honor, responsibility, self-confidence, QCC techniques, communication and coordination, team cohesion of all members were all improved obviously. CONCLUSIONS: QCC activity improves the compliance of asthma/COPD outpatients handling inhaler devices and shows the professional service level of clinical pharmacists, which is of significance to the improvement of pharmaceutical care.
品管圈临床药师药学服务哮喘慢性阻塞性肺疾病吸入装置依从性
Quality control circleClinical pharmacistsPharmaceutical careasthmaCOPDInhaler deviceCompliance
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