镇痛药物“三级四维”管理体系在围术期中的构建及应用效果评价

    Construction and Application Effectiveness Evaluation of the “Three Levels, Four Dimensions” Management System of Analgesic Drugs in the Perioperative Period

    • 摘要:
      目的 构建镇痛药物分线分级管理体系,评价其在围术期疼痛管理中的应用效果。
      方法 依据WHO三阶梯镇痛原则,借助PDCA循环法,结合药物风险分级和处方权限控制,构建“三级四维”管理体系。
      结果 通过建立“三级四维”管理体系,不合格处方比率、剩余药液登记不完整比率均有改善,药品批号登记与处方不相符比率、镇痛泵剩余药液回收记录不完整比率等显著改善(P<0.05);并在围术期患者年龄、性别相仿、不增加患者住院天数情况下,阿片类药物的使用疗程、平均用药总剂量、阿片类药物占比都有明显改善(P<0.001)。
      结论 “三级四维”管理体系能够有效平衡镇痛疗效与用药安全,需通过制度设计、技术监管和多学科协作实现精准落地。

       

      Abstract:
      OBJECTIVE To construct a tiered and categorized management system for analgesic drugs and evaluate its application effectiveness in perioperative pain management.
      METHODS Based on the WHO three-step analgesic ladder principle, by using PDCA cycle method, a “three-level, four-dimensional” management model was established by integrating drug risk classification and prescription authority control.
      RESULTS Through the establishment of the “three-level, four-dimensional” support framework, the rates of non-compliant prescriptions and incomplete registration of residual medication showed improvement, while the rates of mismatched drug batch numbers with prescriptions and incomplete recovery records of analgesic pump residual medication were significantly enhanced(P<0.05), furthermore, under comparable patient age and gender and without increasing hospital stay duration, significant improvements were observed in the duration of opioid use, average total dosage, and the proportion of opioid drug costs(P<0.001).
      CONCLUSION The “three-level, four-dimensional” management model effectively balances analgesic efficacy and medication safety which required institutional design, technical supervision, and multidisciplinary collaboration.

       

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