一线药师基于“智慧软件”的医嘱审核效果分析  

Effects of Medical Order Review by First-Line Pharmacists Based on Intelligent Software

作　　者：林燕 史天陆 谢亚文 LIN Yan;SHI Tianlu;XIE Yawen(Dept. of Pharmacy, the First Affiliated Hospital of University of Science and Technology of China/Anhui Provincial Hospital,Anhui Hefei 230001, China;School of Pharmacy, Wannan Medical College, Anhui Wuhu 241000, China)

机构地区：[1]中国科学技术大学附属第一医院/安徽省立医院药剂科,安徽合肥230001 [2]皖南医学院药学院,安徽芜湖241000

出　　处：《中国医院用药评价与分析》2020年第7期882-884,888,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:了解住院药房实施“一线药师+智慧软件”进行医嘱审核服务的效果,分析问题成因,促进临床合理用药。方法:纳入2018年10月至2019年9月中国科学技术大学附属第一医院/安徽省立医院一线药师基于“智慧软件”干预的3504条不合理医嘱,运用Excel软件进行统计分析。结果:3504条不合理医嘱干预的主要原因包括给药剂量不适宜、药物配伍不适宜、溶剂选择不适宜、溶剂量不适宜、给药频次不适宜以及医嘱录入错误等;其中,超说明书用量的构成比最高(1183条,占33.8%),医嘱重复的构成比最低(4条,占0.1%);溶剂量不适宜干预成功率最高,为44.8%(148/330);神经外科不合理医嘱干预成功率最高,为32.6%(239/734)。结论:住院药房一线药师主要负责调剂工作,医嘱审核人员不固定,审核过程依赖“智慧软件”,医嘱审核水平有待提高;应定期对一线药师进行医嘱审核理论培训,对不合理医嘱进行分析总结;建立医嘱集中审核中心,由临床药师及经过医嘱审核培训的专职药师从多方面来进行医嘱审核,提高医嘱审核率及干预成功率。OBJECTIVE:To investigate the implementation effects of First Line Pharmacist+Intelligent Software on medical order review by first-line pharmacists,and to analyze the causes of the problems,so as to promote rational drug use in clinic.METHODS:Totally 3504 irrational medical orders intervened by first-line pharmacists based on Intelligent Software in the First Affiliated Hospital of University of Science and Technology of China/Anhui Provincial Hospital(hereinafter referred to as“our hospital”)from Oct.2018 to Sept.2019 were statistically analyzed with Excel.RESULTS:The main reasons for the intervention of 3504 irrational medical orders were respectively inappropriate dosage,inappropriate drug compatibility,improper selection of solvent,improper amount of solvent,inappropriate frequency of drug administration,and incorrect entry of medical orders.The constituent ratio of off-label dosage was the highest(1183 pieces,33.8%),and the constituent ratio of repeated medical orders was the lowest(4 pieces,0.1%).The success rate of intervention in improper amount of solvent was the highest,totally 44.8%(148/330).The success rate of intervention in neurosurgery was the highest,totally 32.6%(239/734).CONCLUSIONS:The first-line pharmacists in inpatient pharmacy are mainly responsible for the coordination work,the reviewers of medical orders are not fixed,the review process mainly depends on Intelligent Software,and the review level of medical orders needs to be improved.First-line pharmacists should be regularly trained in the theory of medical orders review,and irrational medical orders should be analyzed and summarized.It is necessary to establish a centralized examination center for medical orders,in which clinical pharmacists and full-time pharmacists trained in medical orders review can carry out the review from various aspects,so as to improve the review rate of medical orders and the success rate of intervention.

关 键 词：住院药房 药师 医嘱审核 

分 类 号：R97[医药卫生—药品]