静脉用药调配中心不合理医嘱干预效果分析
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摘要
目的:考察静脉用药调配中心(pharmacy intravenous admixture services,PIVAS)审方药师对不合理医嘱的干预情况,探讨干预效果,以规范临床医师用药,减少不合理医嘱,提高用药安全性、有效性。方法:调取2015—2018年六安市人民医院(以下简称"我院")PIVAS接收的全部静脉用药医嘱,对不合理医嘱进行统计分析。结果:2015—2018年,我院PIVAS接收的医嘱数逐年明显增加,与2017年比较,2018年不合理医嘱所占比例明显降低,差异有统计学意义(P<0.05)。不合理用药医嘱共3 237份,主要为用法与用量不适宜(1 457份,占45%)、溶剂不适宜(1 230份,占38%)。结论:PIVAS的医嘱审核工作使静脉用药不合理医嘱所占比例有所下降,应进一步加强干预,提高合理用药水平。
OBJECTIVE: To investigate the intervention of prescription pharmacists in pharmacy intravenous admixture services(PIVAS)on irrational medical orders,and to probe the intervention effects, so as to regulate drug application by clinicians, reduce irrational medical oders, improve medication safety and effectiveness. METHODS: All the medical orders of intravenous medicine in PIVAS in our hospital during 2015-2018 were collected and analyzed in terms of irrational medical orders. RESULTS: During 2015-2018, the number of medical orders received by PIVAS was markedly increased by years; compared with 2017, the proportion of irrational medical orders had been significantly decreased in 2018, with statistically significant difference(P<0.05). There were 3 237 irrational medical orders in total, mainly included inappropriate usage and dosage(1 457 irrational medical orders, 45%) and improper solvents(1 230 irrational medical orders, 38%). CONCLUSIONS: The examination on medical orders in PIVAS has reduced the proportion of irrational medical orders, and the intervention should be further strengthened to improve the Level of rational drug use.
OBJECTIVE: To investigate the intervention of prescription pharmacists in pharmacy intravenous admixture services(PIVAS)on irrational medical orders,and to probe the intervention effects, so as to regulate drug application by clinicians, reduce irrational medical oders, improve medication safety and effectiveness. METHODS: All the medical orders of intravenous medicine in PIVAS in our hospital during 2015-2018 were collected and analyzed in terms of irrational medical orders. RESULTS: During 2015-2018, the number of medical orders received by PIVAS was markedly increased by years; compared with 2017, the proportion of irrational medical orders had been significantly decreased in 2018, with statistically significant difference(P<0.05). There were 3 237 irrational medical orders in total, mainly included inappropriate usage and dosage(1 457 irrational medical orders, 45%) and improper solvents(1 230 irrational medical orders, 38%). CONCLUSIONS: The examination on medical orders in PIVAS has reduced the proportion of irrational medical orders, and the intervention should be further strengthened to improve the Level of rational drug use.
引文
[1] 瞿丰萍.关于静脉用药医嘱不合理处方的干预分析[J].中国医药指南,2017,15(9):138-139.
[2] 陈虹.静脉用药调配中心的干预管理对临床科室不合理静脉用药的影响[J].中国医药指南,2017,15(1):103-104.
[3] 尹思敏,邹治木,杨磊,等.1476份前列地尔注射液超说明书用药医嘱调查[J].中国医院用药评价与分析,2017,17(2):279-281,284.
[4] 田璞玉,刘莉,向在永.我院PIVAS审核的16300组不合理医嘱分析[J].中国合理用药探索,2017,14(2):41-44.
[5] 位宁,郭晓松,王红红,等.抗菌药物超说明书应用安全性研究分析[J].中国合理用药探索,2017,14(2):53-56.
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[9] 王萍.我院静脉药物配置中心2016年不合理医嘱分析[J].海峡药学,2018,30(2):238-240.
[10] 谭晶,韩玉霞,陈萍,等.医院静脉用药调配中心中药注射剂不合理医嘱分析[J].西南国防医药,2016,26(12):1516-1518.
[11] 唐捷,李林,龙云,等.我院2012—2014年处方点评分析[J].中国执业药师,2016,13(1):3-9,22.
[12] 江楠,邢瑞敏,于靖.PIVAS审方药师对神经外科不合理用药医嘱干预分析[J].药品评价,2018,15(4):27-29,32.
[13] 易娟娟,徐建东,李自冶,等.信息化PIVAS运行初期差错优化及成效分析[J].中国医药导报,2018,15(28):146-149.
[14] 郭志华,周进平.加强军队合理用药管理的实践与体会[J].东南国防医药,2015,17(5):550-552.
[15] 王诗惠,李艳娇,张四喜,等.PIVAS审方药师对不合理用药医嘱的干预与分析[J].中国药事,2018,32(3):388-393.
[16] 傅昌芳,陈昭琳,沈爱宗.临床药师实施医嘱审核对不合理医嘱干预效果分析[J].中南药学,2018,16(10):1446-1449.
[2] 陈虹.静脉用药调配中心的干预管理对临床科室不合理静脉用药的影响[J].中国医药指南,2017,15(1):103-104.
[3] 尹思敏,邹治木,杨磊,等.1476份前列地尔注射液超说明书用药医嘱调查[J].中国医院用药评价与分析,2017,17(2):279-281,284.
[4] 田璞玉,刘莉,向在永.我院PIVAS审核的16300组不合理医嘱分析[J].中国合理用药探索,2017,14(2):41-44.
[5] 位宁,郭晓松,王红红,等.抗菌药物超说明书应用安全性研究分析[J].中国合理用药探索,2017,14(2):53-56.
[6] 李明真.2013—2015年合肥市第三人民医院中药注射剂使用情况分析及合理性评价[J].中国药事,2017,31(3):337-342.
[7] 许利敏.临床药师参与纠正不合理用药效果分析[J].中国现代医生,2016,54(20):89-91.
[8] 张倩,居文政,郭建明,等.2013—2014年南京中医药大学附属医院丹红注射液临床用药合理性分析[J].中国中药杂志,2016,41(4):748-754.
[9] 王萍.我院静脉药物配置中心2016年不合理医嘱分析[J].海峡药学,2018,30(2):238-240.
[10] 谭晶,韩玉霞,陈萍,等.医院静脉用药调配中心中药注射剂不合理医嘱分析[J].西南国防医药,2016,26(12):1516-1518.
[11] 唐捷,李林,龙云,等.我院2012—2014年处方点评分析[J].中国执业药师,2016,13(1):3-9,22.
[12] 江楠,邢瑞敏,于靖.PIVAS审方药师对神经外科不合理用药医嘱干预分析[J].药品评价,2018,15(4):27-29,32.
[13] 易娟娟,徐建东,李自冶,等.信息化PIVAS运行初期差错优化及成效分析[J].中国医药导报,2018,15(28):146-149.
[14] 郭志华,周进平.加强军队合理用药管理的实践与体会[J].东南国防医药,2015,17(5):550-552.
[15] 王诗惠,李艳娇,张四喜,等.PIVAS审方药师对不合理用药医嘱的干预与分析[J].中国药事,2018,32(3):388-393.
[16] 傅昌芳,陈昭琳,沈爱宗.临床药师实施医嘱审核对不合理医嘱干预效果分析[J].中南药学,2018,16(10):1446-1449.