儿科处方/医嘱前置审核规则设置的实践与分析  

Practice and Analysis of Regulation for Pediatric Prescriptions/Medical Orders Pre-Review System

作　　者：张奇 侍晓萍[1] 李中[1] Zhang Qi;Shi Xiaoping;Li Zhong(Dalian Children’s Hospital,Liaoning Dalian 116012,China)

机构地区：[1]大连市儿童医院,辽宁大连116012

出　　处：《儿科药学杂志》2021年第11期18-21,共4页Journal of Pediatric Pharmacy

基　　金：大连市科学技术局科技创新基金项目,编号2019J13SN84。

摘　　要：目的:设计适用于儿科的处方/医嘱前置审核系统,提升处方和医嘱的合格率。方法:(1)建立儿科用药信息库,按循证医学证据等级规范对儿童超说明书用药进行评价;(2)结合儿科用药特点设定处方前置审核规则;(3)对处方/医嘱进行人工及系统点评,比较人工及系统审核一致性,计算合理处方报错率(假阳性)及不合理处方通过率(假阴性);(4)比较前置审核系统上线前后处方/医嘱合格率,比较系统上线前后门诊退药率;(5)通过问卷方式调查医师使用满意度。结果:(1)前置审核系统与人工审核一致率为94.40%,假阳性率为2.51%,假阴性率为3.09%;(2)系统上线前后处方合格率分别为82.13%、87.91%,合格率提升5.78%(P<0.01);(3)门诊退药率由21.94/10000降至13.35/10000(P<0.01);(4)医师满意率为93.75%。结论:我院设计的处方/医嘱前置审核系统适用于儿科用药特点,可提高处方的合格率,降低退药率,得到医师认可,值得同行借鉴。Objective:To design the prescriptions/medical orders pre-review system for pediatrics,so as to improve the qualification rate of prescriptions and medical orders.Methods:(1)Pediatric medication information database was established to evaluate the off-label drug use in children according to the standard of evidence-based medicine.(2)Regulations of prescriptions pre-review system were set up according to the characteristics of pediatric drug use.(3)Manual and systematic reviews of prescriptions/medical orders were performed,consistency of manual and system review was compared,error reporting rate of rational prescriptions(false positive)and pass rate of irrational prescriptions(false negative)were calculated.(4)The qualification rate of prescriptions/medical orders and the drug withdraw rate in outpatient were compared before and after the implementation of pre-review system.(5)The satisfaction of clinicians was analyzed by questionnaire.Results:(1)The consistency rate of the pre-review system and manual review was 94.40%,with the false positive rate of 2.51%and false negative rate of 3.09%.(2)The qualification rates of the prescriptions were respectively 82.13%and 87.91%before and after the implementation of pre-review system,with improvement of 5.78%(P<0.01).(3)The drug withdraw rate in outpatient decreased from 21.94/10,000 to 13.35/10,000(P<0.01).(4)The satisfaction of clinicians reached 93.75%.Conclusion:The prescriptions/medical orders pre-review system designed by our hospital is appropriate for pediatric drug use,which can improve the qualification rate of prescriptions and reduce the drug withdrawal rate.The prescriptions/medical orders pre-review system is recognized by clinicians and worthy of reference by peer reference.

关 键 词：儿科用药 处方/医嘱前置审核 超说明书用药 处方点评 

分 类 号：R969.3[医药卫生—药理学]