我院门急诊静脉药物配置中心不合理医嘱干预分析

摘要

In the present study,we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospital.The irrational medical orders of PIVAS at the outpatient and emergency departments were retrospectively analyzed in Jun.2015.We strengthened the pharmacy intervention on irrational medical orders since July 2015.All the cases were selected by systematic sampling method.Cased studied in Jun.2015 served as the control group,whereas those studied in Jan.2016 served as the intervention group.The irrational rate and the irrational number of daily average were compared between the control group and intervention group.The common type of irrational outpatient and emergency intravenous orders mainly included irrational use of solvents,irrational dosing interval and inappropriate compatibility of drugs.The irrational rate was reduced from 17.4％ to 3.3％ (P＜0.01),and the irrational number of daily average was decreased from 5.23 to 1.00 (P＜0.01).Pharmacy intervention can reduce the irrational rate of medical orders in our hospital,which is of great significance to promote rational drug use and improve medical quality.%本文主要分析常见门急诊静脉不合理医嘱并强调其药学干预作用.回顾性分析了2015年6月我院门急诊静脉药物配置中心(PIVAS)常见的不合理医嘱.于2015年7月起对门急诊静脉处方加强实施药师干预措施.采用系统抽样法以2016年1月抽取的930个病例医嘱作为干预组,2015年6月抽取的900个病例医嘱为对照组,比较加强干预前后两组总不合理率以及日平均不合理医嘱数.结果发现,门急诊静脉不合理医嘱主要包括为溶媒不合理、配伍不合理、给药途径不合理、给药剂量不合理和给药间隔不合理.对照组和干预组基线情况比较(包括性别和科别)无显著性差异(JP＞0.05),不合理率从17.4％降到3.3％(P＜0.01),平均日不合理医嘱数从5.23±1.50下降到1.00±0.77(P＜0.01).从文中可以看出,药学干预可以降低我院医嘱不合理率,这对促进合理用药,提高医疗质量有重要意义.