三级审核肠外营养处方规则的建立和效果评价  

Establish and evaluate effectiveness of three-tier review rules for parenteral nutrition prescriptions

作　　者：邢鹏[1] 王丽丽[1] 陶丽源 刘建平[1] 陈莲珍 XING Peng;WANG Li-li;TAO Li-yuan;LIU Jian-ping;CHEN Lian-zhen(Department of Pharmacy,Beijing Jingmei Group General Hospital,Beijing 102300,China;Department of Pharmacy,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]北京京煤集团总医院药剂科,北京102300 [2]国家癌症中心/国家肿瘤临床医学中心/中国医学科学院北京协和医学院肿瘤医院药剂科,北京100021

出　　处：《肠外与肠内营养》2024年第5期275-279,共5页Parenteral & Enteral Nutrition

摘　　要：目的:通过建立药师三级审核肠外营养医嘱规则,提高肠外营养医嘱合格率,促进肠外营养合理、规范的使用。方法:不同岗位药师全员参与三个审核层级的肠外营养医嘱人工审核干预模式,建立标准化、简单化的肠外营养审核规则,降低审核难度,提高审核效率。结果:实施后,肠外营养医嘱合格率由71.09%提高到95.59%,其中工业化多腔袋合格率达到100%。肠外营养成分单纯性、阳离子浓度、糖脂比、热氮比、给药途径等有明显改善。结论:药师参与三级审核肠外营养模式,可降低单一层级审核风险,促进不同岗位的药师联动,提高审核准确性和审核效率,降低肠外营养不合理使用带来的风险。Objective:To establish a three-tier review rule for parenteral nutrition orders by pharmacists,improve the qualification rate of parenteral nutrition orders,and promote the rational and standardized use of parenteral nutrition.Method:Pharmacists from different positions participate in a manual review intervention model for parenteral nutrition orders at three-tier review,establishing standardized and simplified parenteral nutrition review rules to reduce review difficulty and improve review efficiency.Result:After implementation,the qualified rate for parenteral nutrition orders increased from 71.09%to 95.59%,with a qualified rate of 100%for an industrial multi-cavity bag.The simplicity of parenteral nutrition components,cation concentration,carbohydrate-to-lipid ratio,non-protein calorie-to-nitrogen ratio and route of administration have been significantly improved.Conclusion:The involvement of pharmacists in the three-tier review of parenteral nutrition can reduce the risk of single-tier review,promote collaboration between pharmacists in different roles,improve the accuracy and efficiency of review,and reduce the risk of inappropriate use of parenteral nutrition.

关 键 词：肠外营养 医嘱合理 药师审核 规则建立 三级审核 

分 类 号：R459.3[医药卫生—治疗学]