利用合理用药监测系统促进用药安全及对合理用药监测系统的评价

Promoting safety of drug application by PASS and evaluation of PASS

目的调查并评价合理用药监测系统在临床的使用。方法利用系统查询统计程序,分析我院限定时间内问题医嘱构成、频率和涉及药品等。结果共审查出1 564 337条问题医嘱,其中黑、红2色超过15%,80%以上为配伍禁忌和药物相互作用;重症病房黑、红2色问题医嘱发生率居一级科室首位,平均2条·床^(-1)·d^(-1);阿托品和苯巴比妥注射液居黑色配伍禁忌首位,地高辛与含钙注射液、螺内酯与氯化钾分居黑、红2色药物相互作用首位;儿童警告占全部问题医嘱的1.09%(17 055条),金霉素眼膏居首位。结论合理用药监测系统有助于发现问题医嘱,促进用药安全,但是有诸多问题急需改进。

AIM To investigate and evaluate the proper application of prescription automatic screening system （PASS）. METHODS Using the query-statistic program provided by PASS to retrospectively analyse the composition of problematic medication orders, the occurrence and involevement of high-level alerted prescriptions, and the related drugs. RESULTS A million, five hundred and sixty-four thousand, three hundred and thirty- seven alerts due to problematic orders were generated after the inspection; among them, more than 15 % were black and red alerts, more than 80 % were related to incompatibility and drug-drug interaction （DDI） ; the black and red alerts of critical care unit ranked number one in the first grode departments, with averaged 2 alerts per bed per day; phenobarbitone injection and atropine injection were the most triggered black incompatibility alerts, digoxin and injection with calcium, spironolactone and 10 % potassium chloride injection ranked the first in black and red DDI alerts respectively; child warning occupied 1.09 % of all problematic prescriptions with chlortetracycline hydrochloride eye ointment as the most trigered drug. CONCLUSION Proper application of prescription automatic screening system helps to discover problematic prescripition and promote safe utiligation of drug, but it still has problems to be improved in urgency.