医院自主开发的医嘱审核系统对静脉药物配置中心不合理医嘱的分析和干预
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摘要
目的:对静脉药物配置中不合理医嘱进行分析总结,提高合理用药的水平。方法:采用自行研发的医嘱审核软件对某院静脉医嘱进行审核及干预,收集不合理医嘱,并进行总结分析。结果:2013年1月-2013年6月干预的不合理医嘱共1029份,占总医嘱的0.043%,不合理用药情况主要为:(1)剂量不合理;(2)浓度不合理;(3)给药途径不合理;(4)溶媒不合理;(5)配伍禁忌或相互作用;(6)给药频率不合理;(7)医嘱输入错误;(8)其他不合理用药。结论:审方药师基于医嘱审核软件可及时发现并纠正临床用药不合理现象,且通过对不合理医嘱进行干预、定期总结分析,可有效防止临床因用药不合理引起的不良事件。
OBJECTIVE To analyze the irrational medical orders in Pharmacy Intravenous Admixture Services(PIVAS)to ensure patient's medication safety.METHODS The pharmacists examined all prescriptions in PIVAS of The First Affiliated Hospital of Medicine,Zhejiang University,using their own prescription audit software,then intervened the irrational medical errors.RESULTS All of the irrational medical orders in PIVAS were analyzed and classified from Jan.2013 to Jun.2013,totaled 1029 cases,including improper in drug dose about 8.47%,improper in solvent dose about 7.92%,irrational administration route about 6.56%,unsuitable solvent about 7.51%,incompatibility about 3.69%,improper in medication frequency about 0.82%,order entry mistakes about 59.15%,and other mistakes about 5.87%.CONCLUSION The pharmacists could find out and correct the irrational medical errors timely using their own prescription audit software,thus reducing adverse events.We analyzed the unreasonable orders,which can effectively prevent irrational drug-induced adverse events.
OBJECTIVE To analyze the irrational medical orders in Pharmacy Intravenous Admixture Services(PIVAS)to ensure patient's medication safety.METHODS The pharmacists examined all prescriptions in PIVAS of The First Affiliated Hospital of Medicine,Zhejiang University,using their own prescription audit software,then intervened the irrational medical errors.RESULTS All of the irrational medical orders in PIVAS were analyzed and classified from Jan.2013 to Jun.2013,totaled 1029 cases,including improper in drug dose about 8.47%,improper in solvent dose about 7.92%,irrational administration route about 6.56%,unsuitable solvent about 7.51%,incompatibility about 3.69%,improper in medication frequency about 0.82%,order entry mistakes about 59.15%,and other mistakes about 5.87%.CONCLUSION The pharmacists could find out and correct the irrational medical errors timely using their own prescription audit software,thus reducing adverse events.We analyzed the unreasonable orders,which can effectively prevent irrational drug-induced adverse events.
引文
[1]张健,李岚,王燕琼.静脉给药的配置服务及临床药师的作用[J].中国医院药学杂志,2002,22(6):382.
[2]郑淑萍,付美霞,吴胜林,等.静脉药物配置中心常见不合理用药分析及防范措施[J].中国医院药学杂志,2009,29(12):1047-1048.
[3]罗建华,徐萍,朱增燕.静脉药物配置中心信息系统的建立和应用[J].中国医院药学杂志,2011,31(9):780.
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[5]陈星,任建业,李建富,等.我院静脉用药调配中心不合理医嘱分析及用药干预[J].中国药房,2011,22(42):3950-3952.
[6]郭晓华,杨婉花.静脉配置中心的不合理用药处方调查分析[J].中国医药指南,2010,8(2):11-13.
[7]倪美鑫,徐艳艳,陆勤美,等.药师借助静脉配置中心平台开展肿瘤专科药学服务[J].药学与临床研究,2012,20(6):535-537.
[8]郭向群,张志琴,曹晓宇.静脉药物配液中心不合理处方及不合理配置方法分析[J].医学信息,2010,23(8):2857-2858.
[9]王晓旭,郝建秀,胡文辉.我院门诊输液中抗菌药物使用分析[J].中国医院药学杂志,2006,26(4):490-491.
[10]梁晓美,张国勇,汤晟凌.静脉配置中心不合理用药医嘱调查与分析[J].中国药物与临床,2013,13(2):218-220.
[11]吴光亮,王杏飞,张立寰.发挥静脉药物配置中心及药师的作用,促进临床合理用药[J].中国医院药学杂志,2007,27(11):1612-1613.
[12]施敏,邱洁红.药物静脉配置中心不合理用药分析[J].实用医技杂志,2013,20(6):681-682.
[13]张瑛,习丹,赖小平.维生素K1与维生素C等药物配伍的稳定性研究[J].药品评价,2005,2(5):369.
[14]刘晓琰.我院2003年抗生素不合理处方分析[J].中国医院药学杂志,2005,25(1):86-87.
[15]刘媛,徐嵘,王军,等.上海交通大学医学院附属第六人民医院静脉用药调配中心2010-2012年不合理医嘱分析[J].药学服务与研究,2013,13(2):147-149.
[16]Mahajan R,Singh NR,Singh J,et al.Current scenario of attitude and knowledge of physicians about rational prescription:A novel cross-sectional study[J].J Pharm Bioallied Sci,2010,2(2):132-136.
[17]Soleymani F,Ahmadizar F,Meysamie A,et al.A survey on the factors influencing the pattern of medicine's use:Concerns on irrational use of drugs[J].J Res Pharm Pract,2013;2:59-63.
[18]刘晓琦,杨敏,陈奇.静脉药物配置中心不合理处方分析[J].医药导报,2011,8(30):219-220.
[2]郑淑萍,付美霞,吴胜林,等.静脉药物配置中心常见不合理用药分析及防范措施[J].中国医院药学杂志,2009,29(12):1047-1048.
[3]罗建华,徐萍,朱增燕.静脉药物配置中心信息系统的建立和应用[J].中国医院药学杂志,2011,31(9):780.
[4]胡静,孙艳,杜立民,等.静脉药物配置中心不合理医嘱分析[J].中国药师,2010,13(2):274-276.
[5]陈星,任建业,李建富,等.我院静脉用药调配中心不合理医嘱分析及用药干预[J].中国药房,2011,22(42):3950-3952.
[6]郭晓华,杨婉花.静脉配置中心的不合理用药处方调查分析[J].中国医药指南,2010,8(2):11-13.
[7]倪美鑫,徐艳艳,陆勤美,等.药师借助静脉配置中心平台开展肿瘤专科药学服务[J].药学与临床研究,2012,20(6):535-537.
[8]郭向群,张志琴,曹晓宇.静脉药物配液中心不合理处方及不合理配置方法分析[J].医学信息,2010,23(8):2857-2858.
[9]王晓旭,郝建秀,胡文辉.我院门诊输液中抗菌药物使用分析[J].中国医院药学杂志,2006,26(4):490-491.
[10]梁晓美,张国勇,汤晟凌.静脉配置中心不合理用药医嘱调查与分析[J].中国药物与临床,2013,13(2):218-220.
[11]吴光亮,王杏飞,张立寰.发挥静脉药物配置中心及药师的作用,促进临床合理用药[J].中国医院药学杂志,2007,27(11):1612-1613.
[12]施敏,邱洁红.药物静脉配置中心不合理用药分析[J].实用医技杂志,2013,20(6):681-682.
[13]张瑛,习丹,赖小平.维生素K1与维生素C等药物配伍的稳定性研究[J].药品评价,2005,2(5):369.
[14]刘晓琰.我院2003年抗生素不合理处方分析[J].中国医院药学杂志,2005,25(1):86-87.
[15]刘媛,徐嵘,王军,等.上海交通大学医学院附属第六人民医院静脉用药调配中心2010-2012年不合理医嘱分析[J].药学服务与研究,2013,13(2):147-149.
[16]Mahajan R,Singh NR,Singh J,et al.Current scenario of attitude and knowledge of physicians about rational prescription:A novel cross-sectional study[J].J Pharm Bioallied Sci,2010,2(2):132-136.
[17]Soleymani F,Ahmadizar F,Meysamie A,et al.A survey on the factors influencing the pattern of medicine's use:Concerns on irrational use of drugs[J].J Res Pharm Pract,2013;2:59-63.
[18]刘晓琦,杨敏,陈奇.静脉药物配置中心不合理处方分析[J].医药导报,2011,8(30):219-220.