我院病区不合理用药医嘱Pareto图分析
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摘要
目的:了解我院病区不合理用药情况及原因,为进一步提高医院合理用药水平提供参考。方法:收集整理2017年我院病区的不合理用药医嘱,应用Pareto图分析导致不合理用药医属的主要、次要及一般因素。结果:2017年我院不合理医嘱共计1 925例,具体不合理因素可分为12类。Pareto图分析显示,不合理用药主要因素为给药剂量不当、给药途径不合理、药物浓度不当、输液速度不当,次要因素为溶媒选择不适宜、医嘱录入错误,一般因素为给药频次不合理、无适应证用药、重复给药、禁忌证用药、药物配伍问题或药物不良相互作用、遴选药品不适宜。结论:利用Pareto图,针对不合理用药的因素,进行有效干预和药学服务,可提高医院合理用药水平。
Objective: To investigate the current status and causes of irrational drug use in the wards of our hospital,so as to provide reference for further improving the level of rational drug use.Methods: The irrational medical orders in the wards of our hospital in 2017 were collected and sorted out,and the primary,secondary and general factors of irrational medical orders were analyzed with Pareto diagram.Results: In 2017,there were 1,925 cases of irrational medical orders in our hospital,and the specific irrational factors can be divided into 12 categories.Pareto chart analysis showed that the primary factors were improper dose,irrational administration route,improper drug concentration and improper infusion rate.The secondary factors were inappropriate selection ofsolvent and incorrect admission of medical orders.The general factors were irrational frequency of administration,no indications for medication,repeated administration,contraindications,drug compatibility or adverse drug interactions and improper selection of drugs. Conclusion: By using the Pareto diagram,effective intervention and pharmaceutical service for irrational drug use factors can improve the level of rational use of drugs in hospital.
Objective: To investigate the current status and causes of irrational drug use in the wards of our hospital,so as to provide reference for further improving the level of rational drug use.Methods: The irrational medical orders in the wards of our hospital in 2017 were collected and sorted out,and the primary,secondary and general factors of irrational medical orders were analyzed with Pareto diagram.Results: In 2017,there were 1,925 cases of irrational medical orders in our hospital,and the specific irrational factors can be divided into 12 categories.Pareto chart analysis showed that the primary factors were improper dose,irrational administration route,improper drug concentration and improper infusion rate.The secondary factors were inappropriate selection ofsolvent and incorrect admission of medical orders.The general factors were irrational frequency of administration,no indications for medication,repeated administration,contraindications,drug compatibility or adverse drug interactions and improper selection of drugs. Conclusion: By using the Pareto diagram,effective intervention and pharmaceutical service for irrational drug use factors can improve the level of rational use of drugs in hospital.
引文
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[11]陈云艳,文娱,彭清华.188例住院患者不合理用药医嘱帕累托图分析[J].临床合理用药,2017,10(4C):106-108.
[12]秦利芬,李惠英,任丹阳,等.1 630例儿科不合理处方帕累托图分析[J].中国合理用药探索,2017,14(4):15-17.
[2]国家药典委员会.中华人民共和国药典临床用药须知[S].2015版.北京:中国医药科技出版社,2015:1-1509.
[3]程德云,陈文彬.临床药物治疗学[M].第4版.北京:人民卫生出版社,2012:10-710.
[4]《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[S].2015年版.国卫办医发[2015]43号.
[5]卫生部.卫生部关于印发《医院处方点评管理规范(试行)》的通知[S].2010-02-10.
[6]付虹,邱召娟,戎有和.1 786例静脉用药致药品不良反应/事件的帕累托图分析[J].中国医院用药评价与分析,2016,16(6):832-835.
[7]董志强,赵剑锋,罗燕梅,等.我院2013-2015年门急诊处方不合理因素的帕累托图分析[J].中国药房,2017,28(17):2340-2342.
[8]秦霞,邱峰,龚亚林,等.我院静脉药物配置中心2012年9月-2014年2月抗肿瘤药不合理医嘱分析[J].中国药房,2015,26(2):171-173.
[9]陈新谦,金有豫,汤光.新编药物学[M].第17版.北京:人民卫生出版社,2011:34-959.
[10]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.
[11]陈云艳,文娱,彭清华.188例住院患者不合理用药医嘱帕累托图分析[J].临床合理用药,2017,10(4C):106-108.
[12]秦利芬,李惠英,任丹阳,等.1 630例儿科不合理处方帕累托图分析[J].中国合理用药探索,2017,14(4):15-17.