静脉用药调配中心全肠外营养不合理医嘱类型及预防对策  

Types of irrational medical orders for total parenteral nutrition in pharmacy intravenous admixture service and preventive measures

作　　者：刘欣 孟慧慧 张关敏[1] 李雪梅[1] 张艳华[1] LIU Xin;MENG Huihui;ZHANG Guanmin;LI Xuemei;ZHANG Yanhua(Department of Pharmacy,Peking University Cancer Hospital and Beijing Institute of Cancer Prevention and Control,Key Laboratory of Education Ministry for Malignant Tumor Pathogenesis and Translational Research,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所药剂科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国民康医学》2022年第10期124-127,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨静脉用药调配中心(PIVAS)全肠外营养(TPN)不合理医嘱类型及预防对策。方法:通过医院信息管理(HIS)系统提取2017—2020年PIVAS接收的TPN医嘱,统计并分析不合理医嘱类型,并探讨预防对策。结果:75984组TPN医嘱中,不合理医嘱共881组,占1.16%;医嘱不合理类型包括提交错误(40.52%)、热氮比不合理(16.57%)、糖脂比不合理(12.49%)、医嘱不全面(11.46%)、阳离子浓度高(4.88%)、药品规格不合适(0.34%)和其他(13.73%)。结论:TPN不合理医嘱类型多样,PIVAS审方药师应加强热氮比、糖脂比、医嘱全面性、电解质浓度等医嘱的审核,并对不合理医嘱提出合理化建议,以提高临床营养支持的有效性和安全性,确保患者用药安全。Objective:To explore Types of irrational medical orders for total parenteral nutrition(TPN)in pharmacy intravenous admixture service and preventive measures(PIVAS).Methods:The TPN medical orders received by PIVAS from 2017 to 2020 were extracted through the hospital information management(HIS)system.The types of irrational medical orders were statistically analyzed,and the preventive measures were explores.Results:Among the 75984 groups of TPN medical orders,there were 881 groups of irrational medical orders,accounting for 1.16%.The types of irrational medical orders included errors in incorrect submission(40.52%),unreasonable hot nitrogen ratio(16.57%),unreasonable glucoseto-lipid ratio(12.49%),incomplete medical orders(11.46%),high cation concentration(4.88%),inappropriate drug specification(0.34%)and others(13.73%).Conclusions:There are various types of irrational medical orders for TPN.PIVAS prescription review pharmacists should strengthen the review of medical orders such as hot nitrogen ratio,glucose-to-lipid ratio,comprehensiveness of medical orders,electrolyte concentration and the like,and put forward reasonable suggestions for irrational medical orders so as to improve the effectiveness and safety of clinical nutritional support and ensure the safety of patients’medication.

关 键 词：静脉用药调配中心 全肠外营养 营养支持 不合理医嘱 类型 对策 

分 类 号：R969.3[医药卫生—药理学]