郑州大学附属儿童医院处方前置审核系统的运行实践与分析  

Operation Practice and Analysis of Pre-prescription Review System in Children’s Hospital Affiliated to Zhengzhou University

作　　者：张胜男 白朝辉 刘蕾[1] 闫聪聪 王晓玲[2] Zhang Shengnan;Bai Chaohui;Liu Lei;Yan Congcong;Wang Xiaoling(Children’s Hospital Affi liated to Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450002,China;Beijing Children’s Hospital Affi liated to Capital Medical University,Beijing 100045,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院郑州儿童医院,郑州450002 [2]首都医科大学附属北京儿童医院,北京100045

出　　处：《中国药事》2022年第12期1430-1437,共8页Chinese Pharmaceutical Affairs

基　　金：国家卫生健康委医管中心研究项目(编号国管中心药械处[2019]053)。

摘　　要：目的:分析处方前置审核系统在儿童医院的运行情况,为促进儿童合理用药提供参考。方法:通过审方系统提取郑州大学附属儿童医院2021年4月~2022年3月的门急诊处方,回顾性分析处方前置审核系统判定医师初次开方合格情况、系统判定医师提交处方合格情况,系统判定最终处方合格率情况;比较审方系统建立前后处方合格率;分析假阳性和假阴性处方类型。结果:系统审核处方3065146张。系统判定医师初次开方平均合格率为93.55%,判定医师提交处方平均合格率为97.38%,判定最终处方平均合格率为98.01%。审方系统应用后处方合格率为98.44%,高于审方系统应用前的96.69%,差异有统计学意义(χ^(2)=581.635,P=0.000)。假阳性处方以用法用量不适宜、联合用药不适宜、遴选药物不适宜、临床诊断与用药不符最为常见;假阴性处方以重复用药、遴选药物不适宜、联合用药不适宜、超说明书用药、用法用量不适宜最为常见。结论:儿童医院特色处方前置审核系统的建立及持续维护,可促进临床合理用药,提高门诊处方合格率,降低患儿用药风险。Objective:To analyze the operation of pre-prescription review system in children’s hospital and provide references for reasonable medication in children.Methods:Outpatient and emergency prescriptions were extracted from Children’s Hospital Affiliated to Zhengzhou University from April,2021 to March,2022 through pre-prescription review system.Retrospective analysis was performed on the qualified situation of doctors’initial prescription,the qualified situation of doctors’prescription submission,and the qualified rate of final prescription determined by the system.The qualified rate of prescription was compared before and after the establishment of prescription review system.False positive and false negative prescription types were analyzed.Results:The number of prescriptions reviewed by the system was 3065146 pieces.The system judged that the average qualified rate of physicians’initial prescription was 93.55%,the average qualified rate of prescriptions submitted by physicians was 97.38%,and the average qualified rate of final prescriptions was 98.01%.The qualified rate of prescription after the application of prescription review system was 98.44%,higher than that(96.69%)before the application of prescription review system,and the dif ference was statistically significant(χ^(2)=581.635,P=0.000).The false positive prescriptions usually included inappropriate usage and dosage,inappropriate drug combination,inappropriate drug selection,and inconsistent clinical diagnosis and medication,while the false negative prescriptions usually included repeated drug use,inappropriate drug selection,inappropriate drug combination,of f-label drug use,and inappropriate usage and dosage.Conclusion:The establishment and continuous maintenance of pre-prescription review system of characteristic prescription in children’s hospital can promote rational clinical drug use,improve the qualified rate of outpatient prescription,and reduce the risk of drug use in children.

关 键 词：儿童医院 处方 处方前置审核 合理用药 

分 类 号：R95[医药卫生—药学]