医院合理用药信息化建设创新实践  

Innovative Practice of Information Construction for Rational Drug Use in a Hospital

作　　者：刁瑞刚[1] 王颖琳[1] 陆达 赵泉[1] DIAO Ruigang;WANG Yinglin;LU Da;ZHAO Quan(Yantai Yuhuangding Hospital,Yantai,Shandong,China 264000)

机构地区：[1]烟台毓璜顶医院,山东烟台264000

出　　处：《中国药业》2024年第4期18-22,共5页China Pharmaceuticals

摘　　要：目的提高医院药事管理效能,促进临床合理用药。方法医院药学部以原有合理用药信息化系统知识库为基础,建立了以问题为导向的双联合工作机制,主要表现为信息药师针对临床药师事后点评发现的用药问题建立管控方案,编写管控规则,不断完善知识库,通过信息化在处方和医嘱前置审核环节进行管控。在此基础上,对重点项目(如门诊适应证、围术期抗菌药物、抗肿瘤药物管理等)建立系统管控方案。结果2020年至2022年,共改进、优化基础知识库规则5266项,建立了具备564项自定义规则的自定义知识库;实现合理用药信息化系统版本升级4次,系统创新与改进32项;门诊/住院次均药品费用增幅、门诊处方合理率、住院医嘱合理率、抗菌药物使用强度等药事管理指标改善明显。结论构建全面的合理用药监管体系,能有效提升医院药事管理水平与药学服务能力,促进临床合理用药水平的提升。Objective To improve the efficiency of pharmaceutical administration in a hospital,and to promote the rational drug use in clinical practice.Methods Based on the knowledge database of the original rational drug use information system,the Department of Pharmacy of the hospital constructed a problem-based dual-joint working mechanism,which mainly included that information pharmacists constructed a control plan for the medication problems found by the clinical pharmacists in the prescription comment,formulated the control rules,improved continuously the knowledge database,and carry out the intervention in the pre-review of prescription and medical orders through information technology.On this basis,a systematic control plan was constructed for key items such as outpatient indications,perioperative antibiotics and anti-tumor drug management.Results A total of 5266 rules in the basic knowledge database were improved and optimized from 2020 to 2022,and a self-defined knowledge database with 564 self-defined rules was constructed,four upgrades of the rational drug use information system and 32 items of system innovation and improvement were finished.There was a significant improvement in pharmaceutical administration indicators such as the increase in average outpatient/inpatient drug costs,the rational rate of outpatient prescriptions,the rational rate of inpatient orders and the antibiotics use density.Conclusion The construction of a comprehensive regulatory system for rational drug use can effectively improve the hospital pharmaceutical administration level and pharmaceutical care ability,and promote the rational drug use in the clinic.

关 键 词：合理用药信息化系统 知识库 以问题为导向 工作机制 药事管理 药学服务 

分 类 号：R95[医药卫生—药学]