基于智能信息管理系统的门诊麻精药品全流程管理  

Whole process management of narcotic drugs and psychotropic drugs based on intelligent information management system

作　　者：史香芬[1] 孙志勇[1] 张旭锋 卢晓静 杜书章[1] 张晓坚[1] SHI Xiangfen;SUN Zhiyong;ZHANG Xufeng;LU Xiaojing;DU Shuzhang;ZHANG Xiaojian(Department of Pharmacy,First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450052,China)

机构地区：[1]郑州大学第一附属医院药学部,河南郑州450052

出　　处：《中国药物警戒》2023年第8期899-903,共5页Chinese Journal of Pharmacovigilance

基　　金：国家科技重大专项新药创制(2020ZX09201-009);河南省医学科技攻关计划软科学项目(RKX202202027)。

摘　　要：目的基于临床合理用药管理系统和医院信息管理系统规范门诊麻精药品处方审核与调剂流程。方法运用焦点管理循环模式(FOCUS-PDCA)循环法聚焦问题、发现问题、原因分析、对策拟定、实施改进措施,通过临床合理用药管理系统设置麻精药品适应证、用法用量、用药疗程等精细化审核规则;医师通过医院信息系统(HIS)中的电子病历系统建立癌症疼痛患者和中、重度慢性疼痛患者门诊病历,药师查询患者是否住院及历史处方取药间隔后调配处方。结果对8种麻醉和第一类精神药品、7种第二类精神药品分别设置精细化审核规则;门诊癌症疼痛患者和中、重度慢性疼痛患者均建立电子病历。门诊麻醉药品和第一类精神药品处方退费率由11.41%降低到2.32%,第二类精神药品处方合理率由86.81%提升至97.83%。结论通过精细化设置麻精药品处方审核规则、规范麻精药品处方调剂流程等措施实现了门诊麻精药品全流程管理,提高了门诊麻精药品处方合理率,确保了患者用药的合理性和安全性。Objective To standardize the prescription review and dispensing process of outpatient anesthetics based on the clinical rational drug use management system and hospital information system.Methods The FOCUS-PDCA method was used to identify problems,analyze the causes,formulate and implement interventions.The management system for clinical rational drug use was used to set up detailed audit rules for the indications,usage and dosage and courses of treatment.Pharmacists established medical records of outpatients with cancer pain via the electronic medical record system in the hospital information system(HIS).They also adjusted prescriptions after finding out whether an outpatient was hospitalized and when previous drugs were dispensed with.Results According to drug instructions and related laws and regulations,detailed audit rules were formulated for 8 categories of narcotic drugs and class Ⅰ psychotropic drugs and for 7 categories of class Ⅱ psychotropic drugs.Electronic medical records of outpatients were established for cancer patients.The refund rate of outpatient prescriptions for narcotic drugs and class Ⅰ psychotropic drugs decreased from 11.41% to 2.32%,and the rate of standard use of class Ⅱ psychotropic drugs increased from 86.81% to 97.83%.Conclusion The whole process management of narcotic drugs and psychotropic drugs for outpatients can improve the rate of standard prescriptions,and ensure the rationality and safety of patients’medication.

关 键 词：麻醉药品 精神药品 临床合理用药管理系统 医院信息系统 PDCA 处方合理率 

分 类 号：R994.11[医药卫生—毒理学]