静脉用药集中调配中心审方系统改进前后抗肿瘤药不合理医嘱对比分析  

Comparative Analysis of Irrational Medical Orders of Antineoplastic Drugs Before and After Improvement of Prescription Review System in Pharmacy Intravenous Admixture Services

作　　者：高春侠 杨波[1] 尤海生[1] 庞成森[1] 董卫华[1] 陈思颖[1] GAO Chunxia;YANG Bo;YOU Haisheng;PANG Chengsen;DONG Weihua;CHEN Siying(Dept.of Pharmacy,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院药学部,西安710061

出　　处：《中国医院用药评价与分析》2023年第3期367-370,374,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：陕西省重点研发计划项目(No.2020SF-210)。

摘　　要：目的:了解该院静脉用药集中调配中心(PIVAS)审方系统优化调试前后拦截的抗肿瘤药不合理医嘱情况,为减少临床抗肿瘤静脉用药风险提供参考。方法:对2019年该院PIVAS存在的抗肿瘤药不合理医嘱进行分类及统计分析,2020年逐步优化调试审方系统;对2019年(优化前)、2020年(优化中)和2021年(优化后)PIVAS审核的抗肿瘤药不合理医嘱进行对比分析。结果:2019年、2020年和2021年该院PIVAS接收的抗肿瘤静脉用药医嘱数分别为40 101、34 609和41 117条,拦截的抗肿瘤药不合理医嘱分别为251条(占0.626%)、186条(占0.537%)和77条(占0.187%);与优化前、优化中比较,优化后抗肿瘤药不合理医嘱所占比例明显降低,差异有统计学意义(P<0.05)。涉及的不合理医嘱类型包括溶剂用量不适宜、给药剂量不适宜、溶剂种类不适宜、给药浓度不适宜、给药频次不适宜和医嘱开具不规范。与优化前、优化中比较,优化后溶剂用量不适宜、给药剂量不适宜、溶剂种类不适宜和医嘱开具不规范医嘱所占比例均明显降低,差异均有统计学意义(P<0.05)。结论:PIVAS审方系统的优化,对减少临床不合理医嘱,协助药师精准审核医嘱,促进临床安全、有效地使用抗肿瘤静脉用药具有一定的意义。OBJECTIVE:To investigate the irrational medical orders of antineoplastic drugs intercepted before and after the optimization and debugging of prescription review system in Pharmacy intravenous Admixture Services(PIVAS)of the hospital,so as to provide reference for reducing the risk of clinical antineoplastic intravenous drugs.METHODS:Irrational medical orders of antineoplastic drugs in PIVAS of the hospital in 2019 were classified and statistically analyzed,and the prescription review system was gradually optimized and debug in 2020.Irrational medical orders of antineoplastic drugs reviewed by PIVAS in 2019(before optimization),2020(during optimization)and 2021(after optimization)were compared and analyzed.RESULTS:In 2019,2020 and 2021,the PIVAS respectively received 40101,34609 and 41117 medical orders for intravenous antineoplastic drugs,and 251(0.626%),186(0.537%)and 77(0.187%)intercepted irrational medical orders for antineoplastic drugs.Compared with before optimization and during optimization,the proportion of irrational medical orders of antineoplastic drugs after optimization decreased significantly,the difference was statistically significant(P<0.05).The types of inappropriate medical orders included inappropriate solvent dosage,improper drug dosage,irrational solvent type,inappropriate drug concentration,irrational drug frequency and non-standard medical orders.Compared with those before optimization and during optimization,the proportions of inappropriate solvent dosage,improper drug dosage,irrational solvent type and non-standard medical orders decreased significantly after optimization,the differences were statistically significant(P<0.05).CONCLUSIONS:The optimization of PIVAS prescription review system has a certain significance in reducing irrational medical orders,assisting pharmacists to accurately review medical orders,and promoting the safe and effective use of intravenous antineoplastic drugs in clinic.

关 键 词：静脉用药集中调配中心 审方系统 抗肿瘤药 不合理医嘱 

分 类 号：R969.3[医药卫生—药理学]