临床营养助手程序的研发与应用  

Development and Application of Clinical Nutrition Assistant Program

作　　者：张健[1] 王佳丹 刘荣[1] ZHANG Jian;WANG Jiadan;LIU Rong(Shanghai Public Health Clinical Center,Shanghai,China 201500)

机构地区：[1]上海市公共卫生临床中心,上海201500

出　　处：《中国药业》2024年第10期7-11,共5页China Pharmaceuticals

基　　金：上海市金山区医药卫生类科技创新项目[2021-3-57]。

摘　　要：目的提高临床肠外营养(PN)治疗的安全性。方法临床药师根据PN处方的常见问题,基于Java语言设计研发临床营养助手程序,并参考肠内肠外营养专著、相关指南、专家共识、药品说明书等资料设置系统参数。随机抽取20例需进行PN治疗的患者,由5名医师均分别以人工和使用程序为其开具PN处方(各开具4例),比较开具处方的速率(以人均单张处方开具用时计)和准确率。回顾性分析医院外科2021年1月至5月(程序使用前)和2021年7月至11月(程序使用后)接受PN治疗住院患者的病历各100份,分析PN处方的合理性。结果医师使用程序开具处方的速率为(4.53±0.57)min,准确率为(99.00±0.14)%,显著优于人工开具处方的(16.15±1.54)min和(80.00±0.42)%(P<0.01)。该程序使用后,不合理处方数显著减少(P<0.05),处方改善率为8.70%~44.78%。结论临床营养助手程序的研发和应用提高了医师开具PN处方的效率,保障了PN处方的安全、合理使用。Objective To improve the safety of clinical parenteral nutrition(PN)support.Methods Based on the common problems in PN prescriptions,clinical pharmacists designed and developed a clinical nutrition assistant program by Java language,and set the system parameters according to monographs on enteral and parenteral nutrition,relevant guidelines,expert consensus and drug instructions.A total of 20 patients needing PN support were randomly selected,the PN prescriptions were prescribed by five physicians manually and using the program(each physician prescribed for four cases),the prescribing rate(calculated by per capita time for prescribing a single prescription)and accuracy rate of the two methods were compared.A total of 200 medical records of inpatients receiving PN support in hospital surgery from January to May 2021(before application of program,100 medical records)and from July to November 2021(after application of program,100 medical records)were retrospectively collected to analyze the rationality of PN prescriptions.Results The prescribing rate of physicians using the program was(4.53±0.57)min,and the accuracy rate was(99.00±0.14)%,which were significantly better than(16.15±1.54)min and(80.00±0.42)%by manual prescribing(P<0.01).After the application of this program,the quantity of irrational prescriptions significantly decreased(P<0.05),the improvement rate of prescriptions was in the range of 8.70%to 44.78%.Conclusion The development and application of clinical nutrition assistant program improve the efficiency of physicians in prescribing PN prescriptions,ensure the safe and rational application of PN prescriptions.

关 键 词：临床营养助手程序 肠外营养 处方 合理性 安全性 药事管理 

分 类 号：R95[医药卫生—药学]