临床药师参与的多学科协作全院血糖管理模式介绍与效果评价 点击下载
| 论文标题： | 临床药师参与的多学科协作全院血糖管理模式介绍与效果评价 |
| 英文标题： | |
| 中文摘要： | 目的 介绍临床药师参与的多学科协作全院血糖管理（以下简称“全院血糖管理”）模式，评价其在围手术期糖尿病患者血糖管理中的应用效果。方法介绍南京大学医学院附属鼓楼医院全院血糖管理模式的流程、临床药师工作内容。纳入择期手术的2型糖尿病患者300例，随机分为普通会诊组（对照组）和全院血糖管理组（干预组），比较两组患者血糖管理效果和术前等待时间、住院天数等指标。结果全院血糖管理团队以内分泌科全院血糖管理医师、临床药师、护士为核心成员，主要服务流程分为初次管理、日常管理、出院管理和随访。临床药师作为团队秘书，主要负责每天汇总管理患者的血糖水平及特殊状况，定期进行管理效果评价，开展药学查房、医嘱审核、药学监护，及时对患者血糖进行评估以及指导患者合理用药等工作。与干预前比较，干预3d后，两组患者的空腹血糖、餐后血糖水平均显著降低（P＜0.05），且干预组显著低于对照组（P＜0.05）；与对照组比较，干预组患者的血糖波动幅度显著减小（P＜0.05），其血糖水平标准差已达到目标控制水平，餐后血糖波动幅度、最大血糖波动幅度接近目标控制水平；术前血糖达标率、出院时血糖达标率均显著升高（P＜0.05）；术前等待时间和住院天数均显著缩短（P＜0.05）。结论临床药师参与的多学科协作全院血糖管理模式，可以更加平稳、有效地控制围手术期糖尿病患者的血糖水平，对改善患者的疾病治疗及预后有着现实意义。 |
| 英文摘要： | OBJECTIVE To intr oduce multidisciplinary collaborative blood glucose management mode （hereinafter referred as to blood glucose management mode of the whole hospital ）of the whole hospital with the participation of clinical pharmacists ，and to evaluation it effects on the blood glucose management of perioperative diabetes patients. METHODS The process of blood glucose management mode of the whole hospital in Drum Tower Hospital Affiliated to Medical School of Nanjing University and the work content of clinical pharmacists were introduced. Three hundred patients with type 2 diabetes mellitus who underwent elective surgery were included and randomly divided into general consultation group （control group ）and hospital-wide glucose management group （intervention group ）. The effect of glucose management and indicators such as preoperative waiting time and total length of stay were compared between 2 groups. RESULTS In the blood glucose management team of the whole hospital ，the physicians，clinical pharmacists and nurses of blood glucose management in endocrinology department were the core members ，and the management process was divided into initial management ，daily management ，discharge management and follow-up. As the team secretary ，the clinical pharmacists were mainly responsible for daily summarizing and managing the blood glucose level and special conditions of patients ，regularly evaluating the management effect ，carrying out pharmaceutical ward rounds ，medical order review， pharmaceutical care ， timely assessing the blood glucose of patients and guiding the rational use of drugs. Compared with before intervention ， after 3 days ofintervention，the levels of fasting plasma glucose （FPG）and postprandial blood glucose （PBG） were decreased significantly in 2 groups（P＜0.05）；intervention group was significantly lower than control group （P＜0.05）. Compared with control group ， the fluctuation of blood glucose in intervention group was significantly reduced （P＜0.05），standard deviation of blood glucose had reached the targeted control level ， and the postprandial glucose excursion and the largest amplitude of glycemic excursion were close to the targeted control level ；the rate of bl ood glucose reaching the standard before operation and at discharge were significantly increased （P＜0.05）；the preoperative waiting time and hospitalization days were significantly shortened （P＜0.05）. CONCLUSIONS The multidisciplinary collaborative blood glucose management mode of the whole hospital with the participation of clinical pharmacists can control the blood glucose level of diabetic patients in the perioperative period more stably and effectively ，and has practical significance for the disease treatment and prognosis of patients. |
| 期刊： | 2022年第33卷第17期 |
| 作者： | 计成，代晶，李林通，李佳希，葛卫红 |
| 英文作者： | JI Cheng ，DAI Jing，LI Lintong ，LI Jiaxi，GE Weihong |
| 关键字： | 全院血糖管理；多学科协作；药学服务；临床药师 |
| KEYWORDS： | Whole blood glucose management ；multidisciplinary collaboration ；pharmaceutical care ；clinical pharmacist |
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