处方前置审核系统在中心药房口服药超量医嘱中应用的回顾性分析  

Retrospective Analysis on Application of Prescription Pre-Review System on Medical Orders with Overdose Oral Drugs in Central Pharmacy

作　　者：刘楠楠[1] 阎雨 连雯雯 尹丽梅[1] 毛敏[1] 赫军[1] LIU Nannan;YAN Yu;LIAN Wenwen;YIN Limei;MAO Min;HE Jun(Dept.of Pharmacy,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院药学部,北京100029

出　　处：《中国医院用药评价与分析》2022年第3期381-384,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:通过比较处方前置审核系统实施前后该院中心药房口服药超量医嘱情况,探讨处方前置审核系统在医院处方质量管理中的作用,促进临床合理用药。方法:抽取2017年10月17日至2018年10月16日(处方前置审核系统实施前)和2018年10月17日至2021年9月16日(处方前置审核系统实施后)该院中心药房口服药超量医嘱,进行回顾性分析。结果:处方前置审核系统实施前,该院中心药房口服药超量医嘱涉及的药物主要为心血管系统用药(20.0%,650条/3245条),口服药超量医嘱分布最多的科室为呼吸与危重症医学科(23.6%,766条/3245条)。处方前置审核系统实施后,该院中心药房口服药超量医嘱的发生率降低,由实施前的20.0%(3245条/16201条)降至7.7%(2424条/31630条)。结论:该院口服药超量医嘱涉及品种多,科室分布范围广,超量医嘱的发生比较常见。为了规范医嘱用量,对于超量医嘱所占比例较高的品种,应用处方前置审核系统设定规则进行拦截,可明显改善超量医嘱的发生以及临床不合理用药现状,提高住院患者口服药医嘱的质量,促进合理用药。同时,建议医院坚持建立本院的自主维护知识库,对药品进行精细化设置,既能阻止不合理处方/医嘱的开具,又能根据信息提示为患者用药个体化提供依据。OBJECTIVE:To compare the status of medical orders with overdose oral drugs in central pharmacy of this hospital before and after the implementation of prescription pre-review system,and explore the role of the prescription pre-review system in the quality management of hospital prescriptions,so as to promote the clinical rational drug use.METHODS:Retrospective analysis was performed on medical orders with overdose oral drugs in central pharmacy of the hospital from Oct.17,2017 to Oct.16,2018(before the implementation of prescription pre-review system)and from Oct.17,2018 to Sept.16,2021(after the implementation of prescription pre-review system).RESULTS:Before the implementation of prescription pre-review system,drugs involved in medical orders with overdose oral drugs in the central pharmacy of the hospital were mainly cardiovascular system drugs(20.0%,650/3245),and the department with the largest distribution of medical orders with overdose oral drugs was the respiratory and critical care medicine(23.6%,766/3245).After the implementation of prescription pre-review system,the incidence of medical orders with overdose oral drugs in central pharmacy of this hospital decreased from 20.0%(3245/16201)before the implementation to 7.7%(2424/31630).CONCLUSIONS:There are many kinds of drugs in medical orders with overdose oral drugs in central pharmacy of this hospital,the departments are widely distributed,and the occurrence of overdose is relatively common.In order to standardize the dosage of medical orders,prescription pre-review system is used to set rules for the interception,which can significantly improve the occurrence of medical orders with overdose oral drugs and the status of clinical irrational drug use,improve the quality of medical orders with oral drugs for inpatients,and promote the rational drug use.Meanwhile,it is recommended that the hospital establish its own self-maintenance knowledge base and fine-tune the setting of drugs,which can not only prevent the issuance of irrational prescriptions/medical

关 键 词：中心药房 住院患者 前置处方审核系统 口服药超量医嘱 

分 类 号：R97[医药卫生—药品]