临床药师实施病区医嘱点评工作的分析与评价
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摘要
目的研究临床药师对病区医嘱点评工作是否有助于提高临床用药的合理性及探讨今后工作的努力方向。方法收集我院2016年1月至2017年12月的病区医嘱点评数据,按不合理医嘱的问题类型进行汇总统计,并运用帕累托图分析不合理病区医嘱的主要和次要因素。结果对比2016、2017年不合理病区医嘱影响因素结果,组间无冲管和无适应证用药问题均由2016年的主要因素变为2017年的一般因素,且2017年不合理病区医嘱总数较2016年有明显下降。结论医嘱点评对提高临床用药的合理性有一定作用;开展药物重整是促进合理用药的另一种方式。
Objective To study whether clinical pharmacists' comments on lesion medical order can help to improve the rationality of clinical medication and explore the direction of future work. Methods The date of comments on lesion medical order in our hospital fromJanuary 2016 to December 2017 were collected and analyzed according to the types of irrational problems,while Pareto diagramanalysis was performed to find out the main and minor factors of irrational lesion medical order. Results The influencing factors of unreasonable inpatient prescriptions were compared between 2016 and 2017,non-rinse fluid between intravenous groups and non-indication drug usage were both changed fromthe main factor in 2016 to the general factor in 2017,and the total irrational lesion medical orders of 2017 had significantly decreased compared with that of 2016. Conclusion Pharmacists' comments on lesion medical order can improve the rationality of clinical drug use,and medication reconciliation is another way to promote rational drug use.
Objective To study whether clinical pharmacists' comments on lesion medical order can help to improve the rationality of clinical medication and explore the direction of future work. Methods The date of comments on lesion medical order in our hospital fromJanuary 2016 to December 2017 were collected and analyzed according to the types of irrational problems,while Pareto diagramanalysis was performed to find out the main and minor factors of irrational lesion medical order. Results The influencing factors of unreasonable inpatient prescriptions were compared between 2016 and 2017,non-rinse fluid between intravenous groups and non-indication drug usage were both changed fromthe main factor in 2016 to the general factor in 2017,and the total irrational lesion medical orders of 2017 had significantly decreased compared with that of 2016. Conclusion Pharmacists' comments on lesion medical order can improve the rationality of clinical drug use,and medication reconciliation is another way to promote rational drug use.
引文
[1]中华人民共和国国家卫生和计划生育委员会.卫生部关于印发《医院处方点评管理规范(试行)》的通知[EB/OL](2010-02-10)[2016-12-20]. http://www. nhfpc. gov. cn/yzygj/s3590/201003/ac4d04a85da5478793761224abc10fd3.shtml.
[2]中华人民共和国国家卫生和计划生育委员会.中华人民共和国卫生部令(第53号)-处方管理办法[EB/OL].(2006-02-24)[2016-12-20]. http://w w w. nhfpc. gov. cn/mohyzs/s3572/200804/29279. shtml.
[3]梁健华,林平,张威,等.北京积水潭医院1223张门诊不合理处方分析[J].临床药物治疗杂志,2017,15(3):36-40.
[4]陈月,连立超,黄婧,等.门诊不合理用药处方帕累托图分析[J].中国临床药理学杂志,2015,31(13):1325-1327.
[5]王景亮.血塞通注射液不良反应分析及预防措施[J].中国处方药,2016,14(12):49-50.
[6]刘玉芬.我院注射用血塞通(冻干)用药合理性分析[J].内蒙古中医药,2017,36(12):109.
[7]耿魁魁,刘圣,夏宏,等.静脉用药成品输液集中调配溶媒适宜性探讨[J].现代医药卫生,2013,29(8):1144-1147.
[8]朱颖,原野,黄成琼,等.我院现有口服缓控释制剂及其不合理用药分析[J].海峡药学,2016,26(7):150-152.
[9]王丽华,袁耀辉.中药注射剂临床应用需注意的问题[J].中国药物与临床,2005,5(11):881.
[10]杨灿宇,邓丽颖. 1200张中药注射剂处方用药合理性分析[J].中国医院用药评价与分析,2017,17(6):827-829.
[11]闫文理,仝新团,杨胜权.中药注射剂不良反应的原因及其对策[J].现代中医药,2016,36(3):56-57,79.
[12]蒋蔚茹,钟良.氯吡格雷与质子泵抑制剂的相互作用[J].上海医药,2013,34(21):16-19.
[13]徐姗姗,赵环宇,李荔,等.临床药师开展药物重整服务在防范用药差错中的作用与实践[J].实用药物与临床,2015,18(6):709-711.
[14]龚元凤,赵洪伟,刘子琦,等.高血压患者的药物重整服务与药学监护[J].实用药物与临床,2017,20(1):80-83.
[15]张杰,李沁园,于玲,等.药物重整模式应用于严重药物性肝损伤患者的药学实践初探[J].实用药物与临床,2016,19(11):1413-1416.
[2]中华人民共和国国家卫生和计划生育委员会.中华人民共和国卫生部令(第53号)-处方管理办法[EB/OL].(2006-02-24)[2016-12-20]. http://w w w. nhfpc. gov. cn/mohyzs/s3572/200804/29279. shtml.
[3]梁健华,林平,张威,等.北京积水潭医院1223张门诊不合理处方分析[J].临床药物治疗杂志,2017,15(3):36-40.
[4]陈月,连立超,黄婧,等.门诊不合理用药处方帕累托图分析[J].中国临床药理学杂志,2015,31(13):1325-1327.
[5]王景亮.血塞通注射液不良反应分析及预防措施[J].中国处方药,2016,14(12):49-50.
[6]刘玉芬.我院注射用血塞通(冻干)用药合理性分析[J].内蒙古中医药,2017,36(12):109.
[7]耿魁魁,刘圣,夏宏,等.静脉用药成品输液集中调配溶媒适宜性探讨[J].现代医药卫生,2013,29(8):1144-1147.
[8]朱颖,原野,黄成琼,等.我院现有口服缓控释制剂及其不合理用药分析[J].海峡药学,2016,26(7):150-152.
[9]王丽华,袁耀辉.中药注射剂临床应用需注意的问题[J].中国药物与临床,2005,5(11):881.
[10]杨灿宇,邓丽颖. 1200张中药注射剂处方用药合理性分析[J].中国医院用药评价与分析,2017,17(6):827-829.
[11]闫文理,仝新团,杨胜权.中药注射剂不良反应的原因及其对策[J].现代中医药,2016,36(3):56-57,79.
[12]蒋蔚茹,钟良.氯吡格雷与质子泵抑制剂的相互作用[J].上海医药,2013,34(21):16-19.
[13]徐姗姗,赵环宇,李荔,等.临床药师开展药物重整服务在防范用药差错中的作用与实践[J].实用药物与临床,2015,18(6):709-711.
[14]龚元凤,赵洪伟,刘子琦,等.高血压患者的药物重整服务与药学监护[J].实用药物与临床,2017,20(1):80-83.
[15]张杰,李沁园,于玲,等.药物重整模式应用于严重药物性肝损伤患者的药学实践初探[J].实用药物与临床,2016,19(11):1413-1416.