我院病区及手术室麻醉药品的使用及不合理处方分析
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摘要
目的分析我院病区及手术室麻醉药品的使用及不合理处方,为加强麻醉药品精细化管理和提高处方书写质量提供依据。方法统计2017年1月~2018年6月我院病区及手术室麻醉药品用量,并根据电子处方录入时的序数字标号进行盲法随机抽取病区及手术室麻醉处方17921张进行分析。结果我院2017年1月~2018年6月使用的麻醉药品,按最小包装统计前10品种,其中包括5种注射液,2种缓释片剂,2种普通片剂和1种透皮贴剂,前三位的分别是枸橼酸芬太尼注射液、硫酸吗啡缓释片和芬太尼透皮贴;在本研究统计的药物中,销售金额最高的前三位分别是:芬太尼透皮贴(22.43%)、枸橼酸芬太尼注射液(21.79%)及注射用盐酸瑞芬太尼(16.55%);896张处方中手术室636张(70.98%),病区260(29.78%),其中不规范处方533张(59.49%),不适宜处方363张(40.51%)。结论我院麻醉药品种类齐全,药品应用基本合理,但仍需进一步加强麻醉药品的精细化管理,规范处方书写,以保障麻醉药品的准确调配与科学使用。
Objective To analyze the use of narcotic drugs and unreasonable prescriptions in the ward and operating room of our hospital to provide a basis for strengthening the fine management of narcotic drugs and improve the quality of prescription writing. Methods The amount of narcotic drugs in the ward and operating room of our hospital from January2017 to June 2018 was statistically analyzed.According to the serial number of the electronic prescription input,17921 pieces of anesthesia prescriptions in the ward and operating room were randomly selected for analysis. Results The top10 types of narcotic drugs used in our hospital from January 2017 to June 2018 were counted according to the minimum packaging,including 5 injections,2 sustained-release tablets,2 common tablets and 1 transdermal patch.The top three were fentanyl citrate injection,morphine sulfate sustained release tablets and fentanyl transdermal patch.Among the drugs counted in this study,the top three sales were fentanyl transdermal patch(22.43%),fentanyl citrate injection(21.79%)and remifentanil hydrochloride for injection(16.55%).Among the 896 pieces of prescriptions,636 pieces were from operating rooms(70.98%)and 260 pieces were from wards(29.78%).Among them,there were 533 unregulated prescriptions(59.49%)and 363 inappropriate prescriptions(40.51%). Conclusion The hospital has a complete range of anesthetic drugs,and the application of drugs is basically reasonable.However,it is still necessary to further strengthen the fine management of narcotic drugs and standardize prescription writing to ensure the accurate deployment and scientific use of narcotic drugs.
Objective To analyze the use of narcotic drugs and unreasonable prescriptions in the ward and operating room of our hospital to provide a basis for strengthening the fine management of narcotic drugs and improve the quality of prescription writing. Methods The amount of narcotic drugs in the ward and operating room of our hospital from January2017 to June 2018 was statistically analyzed.According to the serial number of the electronic prescription input,17921 pieces of anesthesia prescriptions in the ward and operating room were randomly selected for analysis. Results The top10 types of narcotic drugs used in our hospital from January 2017 to June 2018 were counted according to the minimum packaging,including 5 injections,2 sustained-release tablets,2 common tablets and 1 transdermal patch.The top three were fentanyl citrate injection,morphine sulfate sustained release tablets and fentanyl transdermal patch.Among the drugs counted in this study,the top three sales were fentanyl transdermal patch(22.43%),fentanyl citrate injection(21.79%)and remifentanil hydrochloride for injection(16.55%).Among the 896 pieces of prescriptions,636 pieces were from operating rooms(70.98%)and 260 pieces were from wards(29.78%).Among them,there were 533 unregulated prescriptions(59.49%)and 363 inappropriate prescriptions(40.51%). Conclusion The hospital has a complete range of anesthetic drugs,and the application of drugs is basically reasonable.However,it is still necessary to further strengthen the fine management of narcotic drugs and standardize prescription writing to ensure the accurate deployment and scientific use of narcotic drugs.
引文
[1]陈晓宇,王大明,王宏宇.骶管阻滞复合小剂量氯胺酮-芬太尼麻醉用于小儿手术治疗的效果和安全性[J].中国医药科学,2012,2(12):93-94.
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[7]王瑞君,朱晓虹,王咏梅,等.智能毒麻药管理柜在我院住院西药房的应用评价[J].中国药房,2015,26(16):2241-2243.
[8]陈晓莉,张瑞,楚尧娟,等.智能麻醉药品管理系统在我院麻醉科的应用实践及体会[J].中国药房,2015,26(16):2247-2250.
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[10]陈冯琳,董舒婧,陈春玲,等.5S管理法用于麻醉科医院感染控制的调查[J].中华医院感染学杂志,2015,25(22):5256-5258.
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[12]朱斌,马爽,黄宇光.围术期手术麻醉安全体系的构建[J].中国医院管理,2015,35(7):35-36.
[13]江莉,陈丹镝,樊王冬,等.某三甲医院2012-2014年麻醉药品和第一类精神药品使用分析[J].中国药房,2015,26(35):4912-4915.
[14]叶芳,黄文起.加速康复外科发展与完善麻醉管理[J].广东医学,2016,37(18):2692-2695.
[15]罗婷,吴安石.日间手术麻醉的管理[J].临床麻醉学杂志,2016,32(10):1027-1030.
[16]王静,杨婉花,杨莉,等.我院门诊麻醉药品管理信息化建设与实践[J].中国药房,2017,28(1):95-98.
[17]刘家民.基层医院麻醉药品的管理与使用[J].中国医药科学,2011,1(11):132-136.
[18]孙政进,金红.宣城市10家医疗卫生机构麻醉药品和第一类精神药品使用管理专项检查情况分析[J].中国药房,2015,26(7):875-878.
[2]陈鸣.中国麻醉药品管理历史沿革及医疗机构麻醉药品管理[J].中国医院药学杂志,2015,35(5):375-379.
[3]高学敏,王永炎.中华人民共和国药典临床用药须知[M].人民卫生出版社,2005:66-84.
[4]曹信杰.贯彻《麻醉药品和精神药品管理条例》让痛者不痛[J].药学实践杂志,2006,24(4):234-235.
[5]陈炎,陈亚蓓,陶荣芳.医院处方点评管理规范(试行)[J].世界临床药物,2010,31(3):259-260.
[6]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《麻醉药品临床应用指导原则》的通知[Z].2007-01-25.
[7]王瑞君,朱晓虹,王咏梅,等.智能毒麻药管理柜在我院住院西药房的应用评价[J].中国药房,2015,26(16):2241-2243.
[8]陈晓莉,张瑞,楚尧娟,等.智能麻醉药品管理系统在我院麻醉科的应用实践及体会[J].中国药房,2015,26(16):2247-2250.
[9]顾宝晨,陈蓉,包健安.智能麻醉药品管理机在我院门诊药房麻醉药品管理中的应用[J].中国药房,2015,26(25):3534-3536.
[10]陈冯琳,董舒婧,陈春玲,等.5S管理法用于麻醉科医院感染控制的调查[J].中华医院感染学杂志,2015,25(22):5256-5258.
[11]刘勇,吴晓明,顾建琴.我国麻醉药品监管发展问题及域外启示[J].中国新药杂志,2015,24(22):2540-2543,2554.
[12]朱斌,马爽,黄宇光.围术期手术麻醉安全体系的构建[J].中国医院管理,2015,35(7):35-36.
[13]江莉,陈丹镝,樊王冬,等.某三甲医院2012-2014年麻醉药品和第一类精神药品使用分析[J].中国药房,2015,26(35):4912-4915.
[14]叶芳,黄文起.加速康复外科发展与完善麻醉管理[J].广东医学,2016,37(18):2692-2695.
[15]罗婷,吴安石.日间手术麻醉的管理[J].临床麻醉学杂志,2016,32(10):1027-1030.
[16]王静,杨婉花,杨莉,等.我院门诊麻醉药品管理信息化建设与实践[J].中国药房,2017,28(1):95-98.
[17]刘家民.基层医院麻醉药品的管理与使用[J].中国医药科学,2011,1(11):132-136.
[18]孙政进,金红.宣城市10家医疗卫生机构麻醉药品和第一类精神药品使用管理专项检查情况分析[J].中国药房,2015,26(7):875-878.