医院门诊前置审方系统应用效果初探  

Application Effect of Pre-Prescription Review System in a Hospital Outpatient Department

作　　者：汪星辉[1] 王凤玲 曹荣娟 胡娟 孟祥云[1] WANG Xinghui;WANG Fengling;CAO Rongjuan;HU Juan;MENG Xiangyun(Department of Pharmacy,The Second People′s Hospital of Hefei·Affiliated Hefei Hospital of Anhui Medical University,Hefei,Anhui,China 230011)

机构地区：[1]安徽省合肥市第二人民医院·安徽医科大学附属合肥医院药学部,安徽合肥230011

出　　处：《中国药业》2022年第13期21-24,共4页China Pharmaceuticals

基　　金：国家自然科学青年科学基金[82003849];安徽省合肥市第二人民医院光华青年科研基金[2020qnjj41];安徽省合肥市第二人民医院2020年度院级科研项目[2020ygkt53]。

摘　　要：目的探讨前置审方系统(以下简称系统)用于医院门诊的效果,以提高合理用药水平。方法系统采用“软件审核为主+药师审核为辅”的复合型审方模式,收集2020年8月至11月该院系统上线后审方中心平台数据的样本,统计并分析审方干预的成效和存在的问题,并提出改进措施。结果2020年8月至11月,系统审核处方不合理率分别为37.67%(6156/16344)、25.83%(5805/22477)、18.16%(4212/23188)、16.95%(4320/25480),药师对处方的干预率分别为68.51%(124/181)、63.20%(146/231)、52.83%(84/159)、54.96%(155/282),干预后处方合理率分别为68.75%(11231/16336)、88.51%(19888/22469)、89.70%(20797/23186)、91.14%(23223/25480);不合理处方问题主要表现为超多日用量、超适应证、超剂量,分别占34.81%(14762/42405)、32.50%(13782/42405)、20.16%(8548/42405);不合理处方问题数排名前3的科室分别为门诊内科、简易门诊和神经内科,分别占63.77%(25991/40756)、14.50%(5909/40756)、7.28%(2965/40756);系统审核预警问题共42406个,红灯、橙灯、黑灯警示问题分别占59.23%,36.80%,3.97%。结论该系统的应用可提高该院处方的合理率,减轻药师的审方负担,提升药师的职业价值,促进临床合理用药,保障患者用药安全。Objective To investigate the application effect of pre-prescription review system(hereinafter referred to as system)in a hospital outpatient department,and to promote rational drug use.Methods The system adopted a compound review mode of"prescriptions were mainly reviewed by a software,followed by pharmacists".The data samples from the central platform of prescription review after the hospital system went online from August to November 2020 were collected to count and analyze the effectiveness,existing problems of the intervention of prescription review,and improvement measures were put forward.Results From August to November 2020,the irrational rates of prescriptions reviewed by the system were 37.67%(6156/16344),25.83%(5805/22477),18.16%(4212/23188)and 16.95%(4320/25480),respectively.The intervention rates of pharmacists on prescriptions were 68.51%(124/181),63.20%(146/231),52.83%(84/159)and 54.96%(155/282),respectively.The rational rates of prescriptions after intervention were 68.75%(11231/16336),88.51%(19888/22469),89.70%(20797/23186)and 91.14%(23223/25480),respectively.The problems of irrational prescription were mainly over-day dosage,off-indication drug use and overdosage,accounting for 34.81%(14762/42405),32.50%(13782/42405)and 20.16%(8548/42405),respectively.The top three departments for the number of problems of irrational prescription were outpatient internal medicine,simple outpatient department and department of internal neurology,accounting for 63.77%(25991/40756),14.50%(5909/40756)and 7.28%(2965/40756),respectively.There were 42406 early warning problems of prescription reviewed by the system,and the problems with early warning of the red light,orange light and black light accounted for 59.23%,36.80%and 3.97%,respectively.Conclusion The application of the system can improve the rational rate of prescription in the hospital,reduce the burden of prescription review of pharmacists,improve the professional value of pharmacists,promote clinical rational drug use,and ensure the safety of drug use of pat

关 键 词：处方前置审核 合理用药 药事管理 

分 类 号：R95[医药卫生—药学]