建立静脉药物配置中心前后静脉用药医嘱合理性分析  

Analysis on Rationality of Intravenous Medication Before and After the Establishment of PIVAS

作　　者：舒向荣[1] SHU Xiangrong(Dept.of Pharmacy,Tianjin Huanhu Hospital,Tianjin 300350,Chin)

机构地区：[1]天津市环湖医院药剂科,天津300350

出　　处：《中国医院用药评价与分析》2018年第6期835-837,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:了解静脉药物配置中心(pharmacy intravenous admixture services,PIVAS)审核调配中发现的医嘱不合理用药情况,为促进临床合理用药提供参考。方法:采用回顾性分析方法,选取2016年3月至2017年2月天津市环湖医院(以下简称"我院")经PIVAS审核调配的用药医嘱96 487份,对不合理用药医嘱进行统计分析;同时,选取2015年3月至2016年2月我院未经PIVAS审核调配的用药医嘱84 375份,比较建立PIVAS前后医嘱用药合理率的变化情况。结果:2015年3月至2016年2月未经PIVAS审核调配的84 375份医嘱中,不合理用药医嘱8 674,份,不合理用药率为10.28%;2016年3月至2017年2月经PIVAS审核调配的96 487份医嘱中,不合理用药医嘱2 431份,不合格用药率为2.52%,较建立PIVAS前大幅降低。2 431份静脉医嘱不合理用药主要表现为用法与用量不适宜、溶剂选择不适宜、溶剂剂量不适宜及用药频次不适宜等;经与临床医师沟通,更正医嘱2 362份,医嘱更正率为97.16%。结论:PIVAS的建立,加强了药师与临床的紧密联系,充分发挥了药师的重要作用。OBJECTIVE： To investigate irrational medication in medical orders examined and deployed by pharmacy intravenous admixture services（ PIVAS）,so as to provide references for clinical rational drug application.METHODS： 96 487 medical orders examined and deployed by PIVAS in Tianjin Huanhu Hospital（ hereinafter referred to ＂our hospital＂） from Mar. 2016 to Feb. 2017 were selected and retrospectively analyzed in terms of irrational medication; meanwhile,84 375 medical orders without examined or deployed by PIVAS in our hospital from Mar.2015 to Feb. 2016 were also extracted for comparing the changes of the rationality of medical orders before and after the establishment of PIVAS. RESULTS： Among the 84 375 medical orders without examined or deployed by PIVAS from Mar. 2015 to Feb. 2016,there were 8 674 irrational medical orders,with the rate of irrational medication of10. 28%; while among the 96 487 medical orders examined and deployed by PIVAS from Mar. 2016 to Feb. 2017,there were 2 431 irrational medical orders,the rate of irrational medication was 2. 52%,which had been significantly decreased than before the establishment of PIVAS. The 2 431 irrational medical orders mainly including inappropriate usage and dosage, improper solvent selection, inaptitude solvent dosage and medication frequency, etc. After discussing with clinicians, 2 362 irrational medical orders had been corrected, with the rate of 97. 16%.CONCLUSIONS： The establishment of PIVAS has reinforced the connection between pharmacists and clinics,which has given full play of the advantages of pharmacists.

关 键 词：静脉药物配置中心 医嘱 处方审核 不合理用药 用药分析 

分 类 号：R969.3[医药卫生—药理学]