基于前置合理用药系统构建医院急诊中心用药规则体系的效果评价  

Effect evaluation of medication rule system in hospital emergency center based on pre-audit rational drug use system

作　　者：周晓 宋惠珠 张碧瑶 马红燕 虞琳 张玲 ZHOU Xiao;SONG Huizhu;ZHANG Biyao;MA Hongyan;YU Lin;ZHANG Ling(Department of Pharmacy,The Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi Municipal People's Hospital,Wuxi,Jiangsu 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院、无锡市人民医院药学部,江苏无锡214023

出　　处：《安徽医药》2024年第3期618-622,共5页Anhui Medical and Pharmaceutical Journal

基　　金：江苏省药学会奥赛康医院药学科研项目(A202322);无锡市科技发展资金项目(Y20212022)。

摘　　要：目的 基于前置合理用药系统构建急诊中心规范化用药规则体系并评价其效果,促进病人用药安全。方法 用计算机随机选取南京医科大学附属无锡人民医院2020年4—7月医疗及智能决策支持系统(MINDs系统)使用前急诊中心2 000张处方和2022年4—7月MINDs系统使用后急诊中心2 000张处方作为研究对象。借助该院前置合理用药系统,建立贴合急诊中心的临床合理用药规则。设计包括日单次疗程、药品适应证、重复用药分类、特殊人群用药剂量、特殊级抗菌药物审核等模块。比较系统使用前后急诊处方点评合格率及规则拦截不合理处方的应用效果。结果 MINDs系统使用前后相比,处方点评不合格率从3.65%(73/2 000)降至0.80%(16/2 000)(P<0.001);系统规则提醒下,医生自主返回修改处方2 858张、刚性拦截处方3 274张。结论 设计符合该院急诊中心的药学监护规则可有效对不合理处方进行拦截和干预,提高急诊中心处方合理率,进一步保障病人用药安全。Objective To construct a standardized medication rules in emergency centers based on the pre-audit rational drug use system and evaluate its effect to promote patient medication safety.Methods A total of 2 000 prescriptions in the emergency center of Wuxi People's Hospital Affiliated to Nanjing Medical University before the use of the Medical and intelligent decision support system(MINDs system) from April to July 2020 and 2 000 prescriptions in the emergency center after the use of MINDs system from April to July 2022 were randomly selected by computer as the research objects.With the help of the pre-audit rational drug use system,the clinical rational drug use rules in emergency center were established.The designs included modules of single daily course of treatment,drug indications,classification of repeated drugs,dosage for special population,and review of special grade antibiotics.The qualified rate of emergency prescription review and the application effect of rules to intercept unreasonable prescriptions were compared before and after the system was used.Results After using MINDs system,the unqualified rate of prescription comment decreased from 3.65%(73/2 000) to 0.80%(16/2 000)(P<0.001).Under the reminder of system rules,doctors voluntarily returned 2 858 prescriptions for modification and 3 274 prescriptions for rigid interception.Conclusion The design of pharmaceutical care rules in line of the emergency center can effectively intercept and intervene unreasonable prescriptions,improve the rational rate of prescriptions in the emergency center,and further ensure the safety of patients' medication.

关 键 词：药学服务 处方 前置审核 合理用药 用药规则 信息化 急诊中心 

分 类 号：R95[医药卫生—药学]