我院骨科83名患者用药合理性及PASS系统适用性研究

Study on Rationality of Drug Use and Adaptivity of PASS of 83 Inpatients in Orthopedics Department

目的:研究我院骨科某病区患者用药合理性,评价临床合理用药监测系统(PASS)的适用性。方法:利用PASS系统对我院骨科某病区83名住院患者医嘱实行监测,分析医生用药合理性;结合临床实际情况,将问题医嘱分为有效提示和无效提示,分析其产生的原因,考察PASS系统的适用性和优缺点。结果:医生共提交医嘱4082条,PASS系统监测医嘱2509条,共有408条提示问题医嘱,其中药物相互作用的有74条,剂量审查的有307条,国内注射液体外配伍的27条。警示级别分类中,黑色警示36条,红色警示58条,橙色警示314条。结合临床实际,列为有效警示信息的有64.7%,无效警示的有35.3%。结论:PASS系统有利于提高临床合理用药水平,但由于该系统智能化程度的不足,造成很多无效提示,因此,PASS系统应该在智能化及个体化用药监测方面加强改进。

Objective： To research the rationality of drug use of inpatients in orthopedics department and evaluate the adaptivity of the prescription automatic screening system （PASS）. Methods： Making use of PASS to screen 83 inpatients medical orders of orthopedics department and analyze their rationality. Under the clinical actual circumstances, these questionable medical orders were divided into effective warning and invalid warning. And the reasons were analyzed, the adaptivity of PASS, the advantages and disadvantages were investigated. Results： 4 082 medical orders were submitted in all and 2 509 of them were monitored by PASS, 408 questionable medical orders were noticed, 74 of them about drug interaction, 307 about the dosage, 27 about injection compatibility. 408 questionable medical orders were classified by warning level, 36 of them were black, 58 were red and 314 were orange. Under the clinical actual circumstances, 64.7% of all the questionable medical orders were effective warning, 35.3% were invalid warning. Conclusion： PASS can prompt rational drug use, while it creates a lot of invalid warning because of its lack of intelligence. The intelligence and the individual monitoring of PASS should be improved.