Continuous improvement on the rationality of prophylactic injectable PPIs usage by a clinical pharmacist-led guidance team at a Chinese tertiary teaching hospital

Abstract

Objective We aimed to evaluate the effects of a clinical pharmacist-led-guidance-team (CPGT) on improving rational prophylactic injectable proton pump inhibitor use (PIPU) and to explore the application of the Plan–Do–Check–Act (PDCA) method in promoting rational PIPU. Methods We conducted a retrospective study among 814 patients at a Chinese tertiary teaching hospital from January 2017 to December 2018. We enrolled 98 patients before the PDCA; 297 and 419 patients were included in first- and second-round PDCA cycles, respectively. The CPGT established the criteria for PIPU and conducted interventions, including medical record reviews, provision of feedback, clinician education, and outcome analysis. We analyzed the appropriateness and costs of PIPU before and after establishment of the PDCA cycle. Results Implementation of continuous CPGT-led intervention and a PDCA cycle significantly decreased the rate of irrational PIPU (53.06% vs. 8.57%), including duration, administration route, indication, and dosing frequency. Costs of total (USD 211.28 ± 162.33 vs. 53.17 ± 22.32) and inappropriate (USD 76.70 ± 59.78 vs. 2.25 ± 3.86) PIPU per patient were significantly reduced. The target compliance rate was 107.56%. Conclusion A CPGT can have an effective role in improving rational PIPU and optimizing administration through a PDCA cycle, to attain improved clinical and economic outcomes.

Changes in the Quality of Life, Psychological Status, Medication Compliance, and Prognosis of Patients with Acute Myocardial Infarction after PCI by Applying PDCA Cycle Management Model

“…In the checking and actioning stage, timely review of feedback and analysis and summary of deficiencies are conducive to timely correcting the patient's management misunderstandings, strengthening the norms of their own behavior, and promoting the e PDCA cycle management model performs cycle quality control on the basis of routine nursing services, formulates more detailed and specific nursing measures, and spirals upward to improve the quality of care, by communicating with patients in time, telling about the serious consequences of not taking medication, inquiring about and recording the patient's medication situation, giving timely feedback on the improprieties in the nursing operation, analyzing the reasons for poor medication compliance of patients, and carrying out the next cycle to improve the self-management of patients' medication. According to the characteristics of patients with AMI, medical staff provide medication guidance to patients in the form of telephone or face-to-face communication, so as to maximize the active initiative of patients in medication and improve medication compliance [19].…”

Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room

“…By emphasizing risk assessment and risk control work, such as standardized management and cleaning of digestive endoscope instruments, it can effectively ensure the safety of surgical treatment and avoid the occurrence of medical infections. [ 34 ] In addition, the application of the PDCA cycle model can effectively strengthen the comprehensive quality of nursing personnel. By providing targeted training and assessment mechanisms, comprehensive skills can be improved, and the mastery of basic knowledge of digestive endoscopy and nursing professional level can be significantly improved.…”

Integrating Multidisciplinary Individualized Medication Recommendations Into the Traditional Pharmacists’ Consultation Method: A Retrospective Study Using Propensity Score Matching Analysis

“…[46][47][48][49] As a result, a series of targeted measures by pharmacists has been implemented, and preliminary improvements have been achieved worldwide. [50][51][52][53] The addition of PPI recommendations in CPCs is our attempt to contribute to this effort. With the continuous promotion of this method, we hope to further rationalize PPI use and reduce unnecessary drug expenditures.…”