前置审核系统在静配中心医嘱审核中的应用  

Application of pre audit system in the medical order audit of the pharmacy intravenous admixture service

作　　者：王岩岩[1] 高婕[1] 李静[1] 崔倩倩 魏业东 陈萍[1] 石志欣 WANG Yanyan;GAO Jie;LI Jing;CUI Qianqian;WEI Yedong;CHEN Ping;SHI Zhixin(Department of Pharmacy,Zibo Central Hospital,Shandong Province,Zibo255036,China)

机构地区：[1]山东省淄博市中心医院药学部,山东淄博255036

出　　处：《中国当代医药》2023年第18期144-147,共4页China Modern Medicine

基　　金：山东省淄博市重点研发计划项目(2018kj010091)。

摘　　要：目的评估前置审核系统在静配中心医嘱审核中的应用效果。方法选取淄博市中心医院医院信息管理系统(HIS)软件升级前(2018年2月至7月)静配中心审核的936283份医嘱、HIS软件升级后(2020年2月至7月)静配中心审核的538601份医嘱及启用前置审核系统后(2022年2月至7月)静配中心审核的707057份医嘱作为研究对象。HIS软件升级前后为人工审核模式,启用前置审核系统后是前置审核系统+人工审核模式。比较HIS软件升级前后及启用前置审核系统后静配中心审核的不合理医嘱率情况。结果应用前置审核系统后,不合理医嘱率低于HIS升级前后,差异有统计学意义(P<0.01);实施HIS软件升级后,不合理医嘱率与HIS升级前比较,差异无统计学意义(P>0.05)。应用前置审核系统后,抗肿瘤药物和中药注射剂的不合理医嘱率低于HIS升级前,差异有统计学意义(P<0.01),抗肿瘤药物的不合理医嘱率低于HIS升级后,差异有统计学意义(P<0.01)。应用前置审核系统后,溶媒选择不合理、给药剂量不合理、剂量与用量不符的不合理医嘱率低于HIS升级前,差异有统计学意义(P<0.01),溶媒选择不合理的不合理医嘱率低于HIS升级后,差异有统计学意义(P<0.01)。结论加强药师对静配中心医嘱的前置审核,是降低不合理医嘱率、提高用药合理性的重要保证。Objective To evaluate the application effect of the pre audit system in the medical order audit of the pharmacy intravenous admixture service.Methods A total of 936283 medical orders reviewed by the Pharmacy Intravenous Admixture Service of Zibo Central Hospital before the software upgrade of the hospital information system(HIS)from February to July 2018,538601 medical orders reviewed by the pharmacy intravenous admixture service after HIS software upgrade(from February to July 2020),and 707057 medical orders reviewed by the pharmacy intravenous admixture service after the pre audit system was started(from February to July 2022)were selected as the research objects.The manual audit mode was used before and after upgrading the HIS software,and the pre audit system+manual audit mode was used after enabling the pre audit system.The rates of unreasonable medical orders reviewed by the pharmacy intravenous admixture service were compared before and after HIS software upgrade and after the pre audit system was enabled.Results After applying the pre audit system,the rate of unreasonable medical orders was lower than that before and after HIS upgrade,and the differences were statistically significant(P<0.01).After the implementation of HIS software upgrade,there was no statistical significance in the rate of unreasonable medical orders compared with that before HIS upgrade(P>0.05).After the pre audit system was applied,the unreasonable orders rates of antitumor drugs and traditional Chinese medicine injections were lower than those before HIS upgrade,and the differences were statistically significant(P<0.01),the rate of unreasonable medical orders of antitumor drugs was lower than that after HIS upgrade,the difference was statistically significant(P<0.01).After the application of the pre audit system,the rates of unreasonable solvent selection,unreasonable dosage and unreasonable medical advice with dose inconsistent with dosage were lower than those before HIS upgrade,and the differences were statistically significant(P

关 键 词：静配中心 医嘱审核 不合理医嘱 前置审核系统 

分 类 号：R969.3[医药卫生—药理学]