我院2014年门急诊小包装中药饮片处方点评  

Prescription Comment of Chinese Herbal Medicine with Small Package in the Outpatient and Emergency Department of Our Hospital in 2014

作　　者：刘道刚[1] 程一帆[1] 王兵[1] 

机构地区：[1]重庆市中医院药剂科,重庆400021

出　　处：《中国药房》2015年第14期1996-1998,共3页China Pharmacy

摘　　要：目的:为处方质量的持续改进提供参考。方法:随机抽取我院门急诊2014年每月某天的小包装中药饮片处方,共5 151张,按照国家和我院制定的有关中药饮片处方的管理规定,对所选处方的合理性以及不合理处方类别和百分比进行点评。结果:5 151张处方中,合理处方为3 237张,占抽查处方的62.84%;不合理处方为1 914张,占抽查处方的37.16%。各类不合理处方数及其构成比依次为:大处方(包括处方金额、剂数、药味数、贵重药质量超过规定等)1 040张,占54.34%;缺中医诊断652张,占34.06%;无煎服法或煎服法不准确108张,占5.64%;急诊处方超3剂56张,占2.93%;调剂复核无双签字39张,占2.04%;缺临床诊断14张,占0.73%;毒性药品超剂量或使用"十八反"药对未注明原因和再次签名4张,占0.21%;诊断与用药不符1张,占0.05%。结论:我院门急诊小包装中药饮片处方总的合格率还不理想,持续改进工作仍需加强。OBJECTIVE： To provide reference for the continuous improvement of prescription quality. METHODS： 515 1 prescriptions of Chinese herbal medicine with small package in the outpatient and emergency departments of our hospital were random- ly selected from one day of each month in 2014. According to the relevant regulations of Chinese herbal medicine prescriptions in China and our hospital, the reasonability of prescriptions, categories and proportion of unreasonable prescriptions were commented. RESULTS： Among the 5 151 prescriptions, 3 237 were reasonable prescriptions （62.84%） and 1 914 were unreasonable （37.16%）. The quantities and composition ratios of unreasonable prescriptions were listed as follows： 1 040 big prescriptions （54.34%） （including prescription cost, dosage numbers, drugs numbers, valuable medicine with excessive weight, etc.）; 652 pre- scriptions lacking of TCM diagnosis （34.06%）; 108 prescriptions with no boiling method or inaccurate boiling method （5.64%）; 56 emergency prescriptions exceeding 3 doses （2.93%） ; 39 adjust check prescriptions with no double signatures （2.04%） ; 14 pre- scriptions lacking of clinical diagnosis （0.73%）; 4 prescriptions with excessive toxic dose or using 18 incompatible medicaments with no reason and re-signature （0.21%） and 1 prescription with no match diagnosis and medication （0.05%）. CONCLUSIONS： The total qualified rate of Chinese herbal medicine with small package in the outpatient and emergency department of our hospital still remains to be improved and continuous effort of prescription regulation shall be strengthened.

关 键 词：门急诊 小包装中药饮片 大处方 处方点评 

分 类 号：R969.3[医药卫生—药理学] R286[医药卫生—药学]