临床药师对某院2016-2017年住院患者用药医嘱点评与分析
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摘要
目的临床药师通过对本院医嘱点评结果的汇总分析,了解本院病房用药情况,以促进临床规范用药,保障患者用药安全。方法采取回顾性分析方法,随机抽取本院2016年7月至2017年7月各病区出院病历共计403份,分析用药的合理性,将不合理用药问题进行归纳、总结、分析。结果 403份病历中,用药不合理病历有40份,占9.9%。不合理医嘱涉及全院13个科室,以普外科、神经外科、骨科等手术科室居多;不合理医嘱类型主要为无指征用药、用法用量不适宜、联合用药不适宜、溶媒选择不当、药物遴选不当。结论本院尚存在不少不合理用药医嘱,临床药师应积极参与临床治疗,针对典型不合理用药问题,对医师定期进行合理用药培训,纠正不合理用药,有助于提高本院合理用药水平。
Objective To determine the drug use in our hospital by medication order evaluation in wards by clinical pharmacists to promote the rational drug use and ensure the safety of drug use. MethodsRetrospectively 31 medical records were randomly selected each month, 403 cases in total from July 2016 to July 2017. Rationality of drug use was analyzed to summarize and analyze irrational drug use. Results There were 40(9.9%) irrational medication orders among the 403 inpatient medical records reviewed. Irrational medical records involved 13 departments with General Surgery, Neurosurgery and Orthopedic Surgery Department as the majority. Irrational drug use mainly included drug use without indications or not suitable indications, irrational usage and dosage, inappropriate drug combinations, improper solvent selection and drug selection. Conclusion The irrational medical orders should be standardized in our hospital. Clinical pharmacists should actively participate in the treatment plan and hold rational drug use trainings regularly, which helps to improve rational drug use in our hospital.
Objective To determine the drug use in our hospital by medication order evaluation in wards by clinical pharmacists to promote the rational drug use and ensure the safety of drug use. MethodsRetrospectively 31 medical records were randomly selected each month, 403 cases in total from July 2016 to July 2017. Rationality of drug use was analyzed to summarize and analyze irrational drug use. Results There were 40(9.9%) irrational medication orders among the 403 inpatient medical records reviewed. Irrational medical records involved 13 departments with General Surgery, Neurosurgery and Orthopedic Surgery Department as the majority. Irrational drug use mainly included drug use without indications or not suitable indications, irrational usage and dosage, inappropriate drug combinations, improper solvent selection and drug selection. Conclusion The irrational medical orders should be standardized in our hospital. Clinical pharmacists should actively participate in the treatment plan and hold rational drug use trainings regularly, which helps to improve rational drug use in our hospital.
引文
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[16]尹航,张尔,于倩.吉林大学中日联谊医院196份药品说明书中溶剂相关信息的调查分析[J].中国医院用药评价与分析,2015,15(12):201-204.
[17]韦翠花,李玉娟,韦璐瑶.浓度和溶媒对胺碘酮输液微粒数影响相关性研究[J].海峡药学,2015,8(27):10-13.
[18]张晓星,张黎明,郑青敏,等.0.9%生理盐水作为胺碘酮注射液的溶媒与5%葡萄糖溶液相比更易导致肝功能异常[J].中国循环杂志,2013,28(8增):162.
[2]胡霓霓,陈琳,王柯静.某院羟乙基淀粉临床应用合理性分析[J].中国药房,2016,12(27):1623-1625.
[3]寻志坤,贾立华.中药注射剂在解放军307医院门诊使用情况分析及应对策略[J].中国临床药理学杂志,2010,26(12):950.
[4]丹参酮ⅡA磺酸钠注射液规范治疗专家组.丹参酮ⅡA磺酸钠注射液临床应用专家建议[J].中华老年心脑血管病杂志,2015,12(17):1261-1264.
[5]钟晓玲.“把脉”保肝药,透视保肝药现状[J].中国处方药,2013,11(1):11-13.
[6]王煜东,侯海佳,候国瑜.保肝药的临床应用分析与展望[J].中国实用乡村医生杂志,2011,18(8):45-46.
[7]缪晓辉.保肝治疗:共识与争议[J].肝脏,2010,1(3):202-203.
[8]应激性溃疡防治专家组.应激性溃疡防治专家建议(2015版)[J].中华医学杂志,2015,95(20):1555-1557.
[9]Biswal S.Proton pump inhibitors and risk for clostridium difficile associated diarrhea[J].Biomed J,2014,37(4):178-183.
[10]Wilhelm SM,Rjater RG,Kale-Pradhan PB.Perils and pitfalls of long-term effects of proton pump inhibitors[J].Expert Rev Clin Pharmacol,2013,6(4):443-451.
[11]Beguin Y,Jsprers A.Iron sucrose-characteristics,effcacacy and regulatory aspects of an established treatment of iron deficiency and iron-deficiency anemia in a broad range of therapeutic areas[J].Expert Opin Pharmacother,2014,15(14):2087-2103.
[12]张均均,华燕艳.右旋糖酐铁与蔗糖铁治疗胃大部切除术后缺铁性贫血的疗效及安全性比较[J].中国药房,2015,26(9):1205-1207.
[13]宋丽娜,申莹,张丽芬,等.蔗糖铁注射液致静脉炎的原因分析及防护[J].总装备部医学学报,2010,12(1):40-42.
[14]杜喜维.氯吡格雷与奥美拉唑联用的合理性探讨[J].医药导报,2016,35(S1):145-146.
[15]成人慢性气道疾病雾化吸入治疗专家组.成人慢性气道疾病雾化吸入治疗专家共识[J].中国呼吸与危重监护杂志,2012,11(2):105-110.
[16]尹航,张尔,于倩.吉林大学中日联谊医院196份药品说明书中溶剂相关信息的调查分析[J].中国医院用药评价与分析,2015,15(12):201-204.
[17]韦翠花,李玉娟,韦璐瑶.浓度和溶媒对胺碘酮输液微粒数影响相关性研究[J].海峡药学,2015,8(27):10-13.
[18]张晓星,张黎明,郑青敏,等.0.9%生理盐水作为胺碘酮注射液的溶媒与5%葡萄糖溶液相比更易导致肝功能异常[J].中国循环杂志,2013,28(8增):162.