某三甲医院门诊处方干预前后对比分析研究

Comparative analysis and study of outpatient prescriptions before and after Intervention in a 3A hospital

目的通过对某院门诊处方的抽样点评,发现存在的问题并对其进行有效的干预,进一步提高临床合理用药水平。方法随机抽取2008年8月-2010年11月16个科室794例门诊处方作为干预前研究资料,按照有关规定对其进行初评和终评,并将结果反馈至所在科室的处方医师,进行有效干预。随机抽取干预后相同16个科室的800例处方作为干预后研究资料,按照公平、公正的原则再次进行点评,并将结果进行统计分析。结果 16个科室处方干预前后的处方合格率分别为41.3%和68.5%,有显著性提高;在处方超量,诊断与用药不符,用法用量不适宜等方面有明显改善;但在抗菌药物使用率和处方平均金额等方面没有显著变化。结论经点评干预后,处方合格率有显著提高,但仍有不合理用药现象,应加强医务人员对处方管理相关法规的培训,不断规范医(药)师的处方行为,促使门诊处方用药做到安全、有效、经济、合理。

Aim To find out problems and make effective intervention,to improve the rational application by sampling and evaluating the outpatient prescription for a certain 3A hospital.Methods With a random sampling method,we selected 794 cases of out-patient prescriptions from 16 clinical departments between August 2008 and November 2010 as research data（pre-intervention）.In accordance with the relevant provisions,we worked out the initial evaluation and final assessment of prescriptions,and fed back to the prescribers and clinical departments where prescription came from,to intervene effectively.After the intervention we selected 800 cases of out-patient prescriptions from the same clinical departments randomly,evaluated prescriptions in a fair and impartial reviews again,and statistically analyzed the results.Results The compliance rate of prescription from 16 clinical departments increased significantly from 41.3%（before intervention） to 68.5%（after intervention）.The problems such as excessive prescription,diagnosis and treatment were not many,and unsuitable dosage improved significantly.However,the antibiotic usage and the average amount of prescription had no significant change.Conclusion After intervention by the comments,prescription compliance rate increases significantly,but there is still the phenomenon of irrational drug use.Medical personnel should strengthen regulations on the prescription management training,continue to regulate the prescribing practices to promote safet,effective,economical and reasonable use of outpatient drugs.