建立处方点评质量管理制度的实践

Quality management by means of comments on prescriptions in the hospital

结合实践，提出高质量处方点评的意义在于：①提高药物治疗的安全性、有效性和经济性；②增强医务人员的循证医学思维和安全用药意识；③优化医院药品的品种结构；④促进医疗品质的持续质量改进。具体实施时应注意：①可采用某日、某段时间处方的回顾性点评或前瞻性点评。点评对象可包括某种药物、某类药物、某类疾病治疗用药、某病历或某医生开具的处方。注意点评对用药教育非常重要、药师可能误认为不合理及有潜在相互作用或有争议的处方。②点评标准要合理，点评过程要体现人性化。③重视计算机对处方点评的辅助作用。

The present paper addresses the implications of proper comments on prescripuons based on practical experience. These implications include： first, safer, more effective and economical medical treatments; second, reinforced thoughts of evidence-based medicine and safe use of drugs; third, optimized varieties of drugs used in the hospital; and fourth, sustained improvement of quality of medical care. When implementing comments on proscriptions, attention should be given to the following aspects： a. retrospective or progressive reviews should be conducted on prescriptions on one day or a period of time. Subjects can be prescriptions of one drug, one kind of drugs, one-disease-specific drugs, one medical record or a prescription by one physician. It should be noticed that comments on prescriptions are very important to education in use of drugs, especially those on controversial prescriptions or ones that pharmacists might consider as unjustified or having potential drug interractions, b. Criteria and process of comments should be rational and people-friendly, c. Function of computers should also be emphasized for their indispensable assistance in commenting on prescriptions.