A Clinical Pharmacist-Led Intervention To Improve The Combination Of Carbapenems And Valproic Acid Using A Focus-Pdca Model

Carbapenems can significantly reduce the blood concentration of valproic acid (VPA), however, the unreasonable combination of VPA and carbapenems was common in our hospital. Therefore, we analyzed the causes of process variation and took corresponding solutions by using FOCUS-PDCA model. Before the implementation of the PDCA cycle, the combined use of carbapenems accounted for 6.56% of all VPA cases, involving 12 clinical departments. After the first cycle, the involving departments decreased to 3, the proportion decreased to 3.65%. After the second cycle, the involving departments reduced to 2, the proportion was further reduced to 2.20%, showing a remarkable difference (p < 0.05). However, although the proportion of combined use decreased from 34.00% to 10.29% in the intensive care unit, there are still many cases of combined use. In summary, through the PDCA cycle, the irrational combination has been improved to some extent, but there is still room for further improvement.