门诊PASS审方干预系统规则精细化管理的实践与效果  

Practice and effect of fine management of rules of PASS prescription intervention system in outpatient clinic

作　　者：郭钦惠 洪璐怡 曹慧敏 钟桂平 GUO Qinhui;HONG Luyi;CAO Huimin(Department of Pharmacy,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518000,China)

机构地区：[1]香港大学深圳医院药学部,广东深圳518000

出　　处：《中国处方药》2025年第7期57-61,共5页Journal of China Prescription Drug

基　　金：吴阶平医学基金会科研专项资助基金(320.6750.2024-11-3)。

摘　　要：目的基于循证药学对合理用药监测系统(PASS)审方干预系统规则进行精细化管理,持续优化审方规则以提升“前置审方系统+审方药师”模式的审方精准度,提高处方质量,减少不合理用药的发生,提高医疗质量与安全。方法通过PASS审方干预系统统计2023年2~4月精细化管理前的处方干预情况,根据帕累托图分析制定规则精细化方案并实施。以2023年2~4月的门急诊处方281436张作为对照组,2024年4~6月的门急诊处方292264张作为观察组。以系统审核通过率、系统拦截率、系统拦截后医生修改率、药师审核率、系统初审处方合格率为主要观察指标;各科室精细化管理前后系统审核的处方不合理率为次要观察指标,评估PASS审方干预系统的规则精细化管理效果。结果规则精细化管理期间(2023年2月~2024年3月)医院共新建或修订6074条审方规则。对照组系统初审的门急诊处方合格率为80.22%,观察组系统初审的门急诊处方处方合格率84.98%,两组比较差异有统计学意义(P<0.001)。观察组系统审核通过率、系统拦截率高于对照组(P<0.001);观察组药师审核率、药师干预率低于对照组(P<0.001)。在规则精细化管理后,观察组产科、急诊科、血管外科、呼吸内科、耳鼻咽喉头颈外科等11个主要科室的系统审核处方不合理率均低于对照组(P<0.001)。结论前置审方系统精细化管理能有效提高前置审方系统的适用性,既能拦截不适宜处方,又能避免过度干预,在提升医生与药师工作效率的同时提高处方质量,有效促进了临床合理用药,提高医院信息化管理水平。Objective Based on evidence-based pharmacy,the rules of the rational drug use monitoring system(Prescription Automatic Screening System,PASS)prescription intervention system are finely managed,and the prescription review rules are continuously optimized to improve the accuracy of prescription review in the mode of"pre-prescription review system+prescription review pharmacist",improve the quality of prescription,reduce the occurrence of irrational drug use,and improve the quality and safety of medical treatment.Methods The prescription intervention before the refined management from February to April 2023 was counted through the PASS review intervention system,and the refinement scheme of rules was formulated and implemented according to the Pareto Diagram Analysis.281436 outpatient and emergency prescriptions from February to April 2023 were used as the control group,and 292264 outpatient and emergency prescriptions from April to June 2024 were used as the observation group.The pass rate of the system audit,the system interception rate,the doctor modification rate after the system interception,the pharmacist audit rate,and the qualified rate of the system's preliminary review prescription were taken as the main observation indexes,and the unreasonable rate of the system's review prescription before and after the refined management of each department was taken as the secondary observation index to evaluate the effect of the pass reviewer's intervention system on the refined management of rules.Results During the period of rule refinement management(February 2023 to March 2024),the hospital has newly built or revised 6074 rules for review.The qualified rate of outpatient and emergency prescriptions in the control group was 80.22%,and the qualified rate of outpatient and emergency prescriptions in the observation group was 84.98%,the difference was statistically significant(P<0.001).The system audit pass rate and system interception rate of the observation group were higher than those of the control group(P<0.001);T

关 键 词：审方规则 精细化管理 合理用药 帕累托图 

分 类 号：R95[医药卫生—药学]