抗肿瘤药物安全管理系统的建立与运行效果分析  

Design and Analysis of the Operation Effect of the Safety Management System for Antitumor Drugs

作　　者：孙雯娟[1] 邹羽真[1] 张凡[1] 张路[2] 赵林[3] 白春梅[3] 张锋 徐燕 茅枫[6] 李菁[7] 顾宇[8] 范欣荣[9] 王孟昭[5] 周道斌[2] 张占杰 赵彬[1] 杜小莉[1] 张波[1] 孙学勤 龙笑[12] 常青 胡冰水 潘慧 吴文铭 SUN Wenjuan;ZOU Yuzhen;ZHANG Fan;ZHANG Lu;ZHAO Lin;BAI Chunmei;ZHANG Feng;XU Yan;MAO Feng;LI Jing;GU Yu;FAN Xinrong;WANG Mengzhao;ZHOU Daobin;ZHANG Zhanjie;ZHAO Bin;DU Xiaoli;ZHANG Bo;SUN Xueqin;LONG Xiao;CHANG Qing;HU Bingshui;PAN Hui;WU Wenming(Department of Pharmacy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Hematology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Medical Oncology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Information Center,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Breast Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Rheumatology and Clinical Immunology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Urology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Medical Affairs,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Administration Office of Western Branch of the Hospital,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Plastic Surgery,Peking Union Med

机构地区：[1]中国医学科学院北京协和医院药剂科,北京100730 [2]中国医学科学院北京协和医院血液内科,北京100730 [3]中国医学科学院北京协和医院肿瘤内科,北京100730 [4]中国医学科学院北京协和医院信息中心,北京100730 [5]中国医学科学院北京协和医院呼吸与危重症医学科,北京100730 [6]中国医学科学院北京协和医院乳腺外科,北京100730 [7]中国医学科学院北京协和医院风湿免疫科,北京100730 [8]中国医学科学院北京协和医院妇产科,北京100730 [9]中国医学科学院北京协和医院泌尿外科,北京100730 [10]中国医学科学院北京协和医院医务处,北京100730 [11]中国医学科学院北京协和医院西院事务管理处,北京100730 [12]中国医学科学院北京协和医院整形美容外科,北京100730 [13]中国医学科学院北京协和医院院办公室 [14]中国医学科学院北京协和医院基本外科,北京100730

出　　处：《协和医学杂志》2022年第3期461-467,共7页Medical Journal of Peking Union Medical College Hospital

摘　　要：目的设计抗肿瘤药物安全管理系统,从处方源头拦截超剂量医嘱,保障抗肿瘤药物临床应用的安全性。方法制订88种抗肿瘤药物阈值拦截/警示策略,建立抗肿瘤药物安全管理系统,对超剂量抗肿瘤药物医嘱进行拦截/警示。调取2021年1—6月抗肿瘤药物安全管理系统中的拦截/警示数据并进行统计分析。结果抗肿瘤药物安全管理系统共拦截/警示医嘱665条,其中触发拦截功能的医嘱共642条(96.54%),触发警示功能的医嘱共23条(3.46%);拦截/警示的药品以口服片剂为主(74.29%);被拦截医嘱中,频次错误占比最高(64.22%),其次为途径错误(11.73%)和剂量错误(9.92%)。拦截超剂量医嘱564条,涉及抗肿瘤药物28种;拦截次数最多的抗肿瘤药物为甲氨蝶呤片,平均超剂量7倍;注射用培美曲塞二钠平均超剂量倍数排名第1,平均超剂量1000倍。拦截超途径医嘱78条,涉及5种抗肿瘤药物。结论抗肿瘤药物安全管理系统从处方环节杜绝了医嘱超剂量用药错误,切实保障了抗肿瘤药物的用药安全。Objective To design a safety management system for antitumor drugs, which can intercept or warn the overdose of medical orders from the prescription source, and ensure the safety of clinical application of antitumor drugs. Methods The threshold of interception and warning strategy of 88 kinds of antitumor drugs were developed, and the safety management system of antitumor drugs was established to intercept or warn the overdose orders. The interception and warning data from January 2021 to June 2021 in the safety management system of antitumor drugs were extracted and analyzed. Results A total of 665 medical orders were intercepted or warned by the safety management system of antitumor drugs, and the majority of the intercepted or warned drugs were oral tablets(74.29%). The intercepted orders were 642(96.54%),and the warned orders were 23(3.46%). Among the intercepted medical orders, frequency error(64.22%) has the highest proportion, followed by route error(11.73%) and dose error(9.92%). A total of 564 medical orders were intercepted, involving 28 kinds of antitumor drugs. Methotrexate tablets ranked first in overdose quantity, with an average of seven times. Pemetrexed ranked first in overdose multiples, with an average overdose of 1000 times. 78 medical orders were intercepted for over pathway, involving 5 kinds of antitumor drugs. Conclusion The safety management system of antitumor drugs can eliminate the error of overdose in prescription and guarantee the safety of antitumor drugs.

关 键 词：抗肿瘤药物 安全管理系统 超剂量 用药安全 

分 类 号：R979.1[医药卫生—药品] R730.53[医药卫生—药学]