Volume 10,Issue 4
A FOCUS PDCA Quality Improvement Model for Reducing the Withdrawal of Traditional Chinese Medicine Injection in Wards
Objective: To explore the application of FOCUS-PDCA quality improvement model to reduce the withdrawal of traditional Chinese medicine injections in the ward. Methods: A total of 780,794 medical orders were selected from November 2023 to January 2024 in our hospital, of which 13,612 medical order were for traditional Chinese medicine (TCM) injections, with a total number of 56,457 units. With the orientation of TCM injection withdrawal in the ward, we used Balaido's law to screen the catalog of medicines whose withdrawal/usage rate exceeded 80% of the total Chinese medicine injection withdrawal, set up a CQI team, and then analyzed the reasons for their withdrawal by using Plato, Fishbone diagram, and “80/20 rule”. Set goals, formulated countermeasures, implemented countermeasures and solved problems. At the same time, we compared the rate of withdrawal/use of TCM injections in the ward before and after the activity, evaluated the effectiveness of FOCUS PDCA in reducing the rate of withdrawal/use of TCM injections in the ward, and standardized the interventions. Results: The number of withdrawals of Shuxuening injection and Guanxinning injection accounted for 94.93% of the total number of TCM injections withdrawn, of which medical order revision, patient discharge, medical order discontinuation accounted for 82.10% of the total reasons for withdrawals of this medicine. With the reduction of the number of withdrawals of Shuxuening injection and Guanxinning injection as the improvement goal, and with the medical order revision, patient discharge, medical order discontinuation as the improvement target, after the implementation of the FOCUS-PDCA quality improvement model, the number of withdrawals/administrations of Shuxuening injection and Guanxinning injection from April 2024 to June 2024 was reduced from 54.30‰ (1/1,000) before the improvement to 36.00‰ (1/1,000), a decrease of 33.70% ; the number of withdrawals/administrations of our total TCM injections decreased from 52.97‰ (1/1,000) to 34.30‰ (1/1,000) (P<0.05), a decrease of 35.25%; and the number of withdrawals/administrations of our total TCM injections decreased from 4.10% to 3.60% (P<0.05), a decreased of 12.20%. At the same time, the error rate of medication withdrawal was significantly reduced compared with that before the improvement (P<0.05). Conclusion: The application of the FOCUS-PDCA quality improvement model could effectively reduce the problem of the withdrawal of TCM injections in the hospital district, reduce the transfer of TCM injections from the pharmacy to the hospital districts, and avoid the quality problems that may arise in the process due to improper storage , so as to improve the safety of patients' use of medicines.
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