PIVAS药师对耳鼻咽喉头颈外科不合理医嘱干预成效分析
|
摘要
目的 PIVAS药师通过对耳鼻咽喉头颈外科实施不合理用药干预,促进临床合理用药。方法采用回顾性分析方法,通过抽取我院静脉配液中心有关耳鼻咽喉头颈外科病房2016年7-12月(干预前)与2017年1-6月(干预后)配液医嘱的审核记录,对不合理用药的情况进行统计学分析;同时,在药师干预前后,对耳鼻咽喉头颈外科病房医师进行合理用药知识考核,并进行组间比较。结果干预前,耳鼻咽喉头颈外科病房15 444条医嘱中不合理配液医嘱214条,不合理占比为1. 39%;干预后,13 884条配液医嘱中不合理配液医嘱44条,不合理占比为0. 32%。干预前后不合理占比差异有统计学意义(χ~2=95. 77,P <0. 05)。干预前不合理类型主要为溶媒选择、给药浓度、给药剂量不适宜,干预后的主要不合理类型与干预前相同。干预前医师的考核成绩中,良好以上者17位(42. 5%),合格者20位(50. 0%),不合格者3位(7. 5%),平均(57. 2±12. 4)分,干预后良好以上者38位(95. 0%),合格者2位(5%),无不合格者,平均(91. 1±7. 6)分。干预前后医师平均考核成绩比较差异有统计学意义。结论 PIVAS药师通过深入临床加强沟通、开展药学服务等措施,可以显著提升科室的合理用药水平,保证了患者的用药安全、有效。
Objective To promote clinical rational drug use by PIVAS pharmacist's intervention in ENT surgical department. Methods A retrospective analysis method was used to sample the medication records in ENT surgical department from July to December 2016( before intervention) and from January to June 2017( after intervention). The prescription records in PIVAS were statistically analyzed. At the same time,the doctors were assessed with reasonable medication knowledge before and after the intervention of pharmacist,and those between the two groups were compared. Results Before intervention,there were 214 unreasonable medication in 15 444 preseription reconrds,and the unreasonable ratio was 1. 39%. After intervention,there were a total of 44 unreasonable medication in 13 884 preseription records,and the unreasonable ratio decreased to 0. 32%. There were significant differences in the unreasonable ratio before and after intervention( χ~2= 95. 77,P < 0. 05). The unreasonable types before or after intervention were mainly solvent selection,concentration of administration,and dose of administration. Among the doctors' assessment scores before the intervention,17( 42. 5%) were good,20( 50. 0%) were qualified,and 3( 7. 5%) were unqualified,the average score being( 57. 2 ± 12. 4); after intervention,38( 95. 0%) were good,2( 5%) were qualified,the average score being( 91. 1 ± 7. 6). The difference in the average scores of physicians before and after intervention was statistically significant. Conclusion PIVAS pharmacists improved the rational drug use by enhancing the communication with clinic and clinical pharmacy services,which ensures safe and effective medication in patients.
Objective To promote clinical rational drug use by PIVAS pharmacist's intervention in ENT surgical department. Methods A retrospective analysis method was used to sample the medication records in ENT surgical department from July to December 2016( before intervention) and from January to June 2017( after intervention). The prescription records in PIVAS were statistically analyzed. At the same time,the doctors were assessed with reasonable medication knowledge before and after the intervention of pharmacist,and those between the two groups were compared. Results Before intervention,there were 214 unreasonable medication in 15 444 preseription reconrds,and the unreasonable ratio was 1. 39%. After intervention,there were a total of 44 unreasonable medication in 13 884 preseription records,and the unreasonable ratio decreased to 0. 32%. There were significant differences in the unreasonable ratio before and after intervention( χ~2= 95. 77,P < 0. 05). The unreasonable types before or after intervention were mainly solvent selection,concentration of administration,and dose of administration. Among the doctors' assessment scores before the intervention,17( 42. 5%) were good,20( 50. 0%) were qualified,and 3( 7. 5%) were unqualified,the average score being( 57. 2 ± 12. 4); after intervention,38( 95. 0%) were good,2( 5%) were qualified,the average score being( 91. 1 ± 7. 6). The difference in the average scores of physicians before and after intervention was statistically significant. Conclusion PIVAS pharmacists improved the rational drug use by enhancing the communication with clinic and clinical pharmacy services,which ensures safe and effective medication in patients.
引文
[1]郁文刘,沈国荣.某院静脉用药调配中心用药医嘱的点评及其不合理医嘱产生的原因分析与对策[J].抗感染药学,2016,13(5):996-998.
[2]涂颖秋,李强,左惠莉,等.静脉用药调配中心不合理用药及干预分析[J].现代医院,2016,16(7):1006-1009.
[3]刘珠英,黄际薇,刘杰.我院PIVAS规范医嘱审核工作实践[J].中国药房,2017,28(31):4462-4464.
[4]史崇智,王国荣,戴敏.我院静脉药物配置中心对不合理医嘱干预成效分析[J].实用医技杂志,2016,23(4):434-435.
[5]王晓剑,邓雪娥.我院静脉用药调配中心不合理用药干预效果分析[J].中国现代医生,2017,55(10):105-108.
[6]陈巧辉,陈德志,许燕玉,等.我院静脉用药调配中心临床不合理用药干预成效分析[J].中国药业,2014,23(18):69-70.
[7]马静,张璐,王牛民,等.静脉药物配置中心不合理医嘱干预中的作用[J].中国药房,2015,26(29):4148-4150.
[8]陈丽娜,王向东,宋广福,等.静脉滴注药物溶剂用量合理性调查分析[J].中国药业,2015,24(11):66-67.
[9]陈幼亭,曹纪兴.时间与浓度依赖性抗菌药物的认识误区简析[J].抗感染药学,2012,9(2):100-101.
[10]张建民,冯玲玲.静脉输液药物配伍禁忌调查[J].中国药房,2006,17(20):1572-1574.
[11]刘晓东,原思佳.头孢曲松钠在联合用药中的配伍禁忌分析[J].中国误诊学杂志,2010,10(9):2250-2251.
[12]刘羽.静脉药物配置不合理医嘱的临床干预对策分析[J].中国现代药物应用,2016,10(4):179-180.
[13]陈晓红.门急诊处方中常见的药物不合理配伍及分析[J].中国医药指南,2013,11(24):110-111.
[14] Machida M,Kusajima H,Aijima H,et al. A toxicokinetic study of norfloxacin-induced arthropathy in juvenile animals[J].Toxicol Appl Pharmacol,1990,105(3):403-412.
[15]《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则(2015年版)[M].北京:人民卫生出版社,2015:57.
[16]陈泽强,林淑瑜.我院PIVAS与临床科室有效沟通的方法探索[J].中国药房,2016,27(28):3949-3952.
[17]石红玲,史雪霞,马秀莲.青海大学附属医院静脉药物配制中心不合理用药分析及药师干预效果研究[J].青海医药杂志,2017,47(1):1-3.
[2]涂颖秋,李强,左惠莉,等.静脉用药调配中心不合理用药及干预分析[J].现代医院,2016,16(7):1006-1009.
[3]刘珠英,黄际薇,刘杰.我院PIVAS规范医嘱审核工作实践[J].中国药房,2017,28(31):4462-4464.
[4]史崇智,王国荣,戴敏.我院静脉药物配置中心对不合理医嘱干预成效分析[J].实用医技杂志,2016,23(4):434-435.
[5]王晓剑,邓雪娥.我院静脉用药调配中心不合理用药干预效果分析[J].中国现代医生,2017,55(10):105-108.
[6]陈巧辉,陈德志,许燕玉,等.我院静脉用药调配中心临床不合理用药干预成效分析[J].中国药业,2014,23(18):69-70.
[7]马静,张璐,王牛民,等.静脉药物配置中心不合理医嘱干预中的作用[J].中国药房,2015,26(29):4148-4150.
[8]陈丽娜,王向东,宋广福,等.静脉滴注药物溶剂用量合理性调查分析[J].中国药业,2015,24(11):66-67.
[9]陈幼亭,曹纪兴.时间与浓度依赖性抗菌药物的认识误区简析[J].抗感染药学,2012,9(2):100-101.
[10]张建民,冯玲玲.静脉输液药物配伍禁忌调查[J].中国药房,2006,17(20):1572-1574.
[11]刘晓东,原思佳.头孢曲松钠在联合用药中的配伍禁忌分析[J].中国误诊学杂志,2010,10(9):2250-2251.
[12]刘羽.静脉药物配置不合理医嘱的临床干预对策分析[J].中国现代药物应用,2016,10(4):179-180.
[13]陈晓红.门急诊处方中常见的药物不合理配伍及分析[J].中国医药指南,2013,11(24):110-111.
[14] Machida M,Kusajima H,Aijima H,et al. A toxicokinetic study of norfloxacin-induced arthropathy in juvenile animals[J].Toxicol Appl Pharmacol,1990,105(3):403-412.
[15]《抗菌药物临床应用指导原则》修订工作组.抗菌药物临床应用指导原则(2015年版)[M].北京:人民卫生出版社,2015:57.
[16]陈泽强,林淑瑜.我院PIVAS与临床科室有效沟通的方法探索[J].中国药房,2016,27(28):3949-3952.
[17]石红玲,史雪霞,马秀莲.青海大学附属医院静脉药物配制中心不合理用药分析及药师干预效果研究[J].青海医药杂志,2017,47(1):1-3.