静脉用药调配中心不合理医嘱帕累托图分析  

Pareto Chart Analysis of Irrational Medical Orders in the Pharmacy Intravenous Admixture Service

作　　者：曾娜婷 陈燕娥 黄泽华 陈美娜 严大鹏 ZENG Nating;CHEN Yan'e;HUANG Zehua;CHEN Meina;YAN Dapeng(Zhongshan Hospital,Fudan University,Xiamen,Fujian,China 361015)

机构地区：[1]复旦大学附属中山医院厦门医院,福建厦门361015

出　　处：《中国药业》2024年第19期5-8,共4页China Pharmaceuticals

摘　　要：目的促进临床合理、安全使用静脉用药物。方法收集医院静脉用药调配中心(PIVAS)2021年7月至2023年6月审核并进行干预的静脉用药不合理医嘱403条,统计科室分布、不合理医嘱类型,计算构成比,绘制帕累托图,分析不合理医嘱的影响因素。结果不合理医嘱分布科室排名前3的分别为普通外科(25.56%)、肿瘤内科(20.10%)、妇科(10.92%)。帕累托图分析显示,溶剂错误、给药剂量错误为主要影响因素,肠外营养医嘱错误为次要影响因素,药物配伍禁忌、给药频次错误为一般影响因素,累计构成比分别为78.91%,86.60%,97.27%。结论医院PIVAS应加强静脉用药医嘱审核,干预不合理医嘱,增加药师与临床的沟通,提升药学服务质量。Objective To promote the clinical rational and safe use of intravenous drugs.Methods A total of 403 irrational intravenous medical orders reviewed and intervened by the hospital pharmacy intravenous admixture service(PIVAS)from July 2021 to June 2023 were collected.The distribution of departments and types of irrational medical orders were statistically analyzed,and the composition ratio was calculated.A Pareto chart was drawn to analyze the influencing factors of irrational medical orders.Results The top three departments with irrational medical orders were the Department of General Surgery(25.56%),Department of Oncology(20.10%),Department of Gynecology(10.92%).Pareto chart analysis showed that solvent errors and dosage errors were the main influencing factors,parenteral nutrition medical errors were the secondary influencing factors,and drug compatibility contraindications and frequency errors of medication were the general influencing factors.The cumulative composition ratios of the three kinds of influencing factors were 78.91%,86.60%,and 97.27%,respectively.Conclusion The irrational medical orders should be intervened by strengthening the review of medical orders in the hospital PIVAS.It was necessary to increase the communication between pharmacists and clinicians,and improve the quality of pharmaceutical care.

关 键 词：静脉用药调配中心 不合理医嘱 处方审核 帕累托图分析 

分 类 号：R95[医药卫生—药学]