某院急诊药房审方与输液流程管理方法的优化对促进合理用药的影响  

Influence of Prescription Checking and Infusion Process Management Optimization on Promoting Rational Drug Use in Emergency Pharmacy in a Hospital

作　　者：韩强[1] 杭永付[1] 郁件康 朱建国[1] HAN Qiang;HANG Yong-fu;YU Fai-kang;ZHU Jian-guo(Department of pharmacy,The No.1 Affiliated Hospital Affiliated to Suzhou University,Suzhou Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院药学部,江苏苏州215006

出　　处：《抗感染药学》2021年第5期660-664,共5页Anti-infection Pharmacy

摘　　要：目的:优化医院急诊药房审方与输液流程管理方法,分析了其对促进合理用药的影响。方法:将急诊药房设置在输液中心旁,并在医院HIS系统中嵌入急诊药房审方软件后,自动监测和审核2019年3月—2020年3月急诊医嘱/处方,分析其自动化机械加药与药师配药以及患者输液流程管理的合理性以及不合理的原因。结果:审方软件自动监测急诊医嘱186 150条,不合理医嘱219条(即不合理率为0.12%),与优化前比较同比下降22.83%(优化前269条);其中溶媒选择不适宜85条(占38.81%、)药物不良相互作用20条(占9.13%)、给药频次不适宜79条(占36.07%)、给药途径不适宜35条(占15.98%);患者与药品零接触避免了药品破损;患者对候药时间、候药方式、候药环境、输液流程的满意度分别提高了10.71%、13.09%、8.33%和13.41%;基本杜绝调配药品中"错配""漏配"等现象。结论:医院急诊药房审方与输液流程管理方法的优化促进了合理用药,杜绝了调配药品中"错配""漏配"等现象的发生,确保了输液药品的质量安全,也促进了患者安全合理用药。Objective: To optimize the management method of prescription checking and infusion process in hospital emergency pharmacy and to analyze its influence on promoting rational drug use. Methods: After the emergency pharmacy was set next to the infusion center and the prescription checking software of the emergency pharmacy was embedded in the hospital HIS, the emergency medical orders/prescriptions from March 2019 to March 2020 were automatically monitored and reviewed, and the rationality and unreasonable reasons of its automatic mechanical dousing,pharmacists’ dispensing and patients’ infusion process management were analyzed. Results: Of the 186 150 emergency medical orders,219 were unreasonable(the unreasonable rate was 0.12%), which decreased by 22.83% compared with269 before optimization. Among them, 85 cases of unsuitable solvent selection accounted for 38.81%, 20 cases of adverse drug interactions accounted for 9.13%, 79 cases of unsuitable drug administration frequency accounted for36.07%, and 35 cases of unsuitable drug administration route accounted for 15.98%. Zero contact between patients and drugs might avoid drug damage. Patients’ satisfaction with waiting time, waiting way, waiting environment and infusion process increased by 10.71%, 13.09%, 8.33% and 13.41%, respectively. The phenomenon of "misallocation" and "omission" in dispensing drugs was basically eliminated. Conclusion: The optimization of prescription checking and infusion process management in hospital emergency pharmacy promotes rational drug use, eliminates the occurrence of "mismatching" and "missing" in dispensing drugs so as to ensure the quality and safety of infusion drugs, and also promote safety and rationality of drug use.

关 键 词：生物净化仓 药师审方 溶媒选择 药物相互作用 医-药-护联合 合理用药 

分 类 号：R969.3[医药卫生—药理学]