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.
引文
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