门诊处方质量调查分析与对策

Survey,Analysis and Countermeasures of Outpatient Prescriptions

目的调查门诊处方质量,了解《处方管理办法》实施后处方不合理状态,为进一步制定和实施临床合理用药的干预措施提供依据。方法采用回顾性调查方法,随机抽查本院2006年1～6月和《处方管理办法》实施后的2011年1～6月两时间段门诊西药处方各2 400张。按照《处方管理办法》的要求分别对处方的合理性进行综合点评及统计分析。结果《处方管理办法》实施前不合格处方456张,处方合格率为81%,实施后不合格处方72张,处方合格率为97%,二者比较有明显差异(P<0.05)。不合理处方在《处方管理办法》实施后其分布特征有一定变化,不规范的处方、超常处方、用药不适宜处方比例均有下降,但前者下降幅度明显优于后二者(P<0.05)。结论《处方管理办法》实施后处方的质量明显提高,不合理处方因素由医务人员责任性向技术性方向转变,提高医务人员专业素质是今后落实《处方管理办法》主要干预措施。

Objective To investigate the quality of outpatient prescriptions, aimed at the irrational use of drugs, so as to provide basis for further intervention. Methods A sample of 2 400 outpatient prescriptions from January to June in 2006 and 2 400 from January to June in 2011 of the hospital, before and after the implementation of Prescription Administration Policy respectively, was randomly selected and analyzed according to the Prescription Administration Policy. Results 456 in 2 400 of 2006 were unqualified, accounting for 19%, while 72 in 2 400 of 2011 were unqualified with rate of 3 %. The statistic analysis shows significant difference （P 〈 0.05 ） between the unqualified rates. Proportions of non - standard prescription, excessive prescription and irrational prescription were all decreased after the implement of Prescription Administration Policy, while the descent ranges in the former have statistical difference superior to that in the later two （ P 〈 0.05 ）. Conclusion There is a significant improvement of prescription quality after the implementation of Prescription Administration Policy. The irrational factors are transforming from doctor responsibility to skill, indicating that the improvement of clinician＇ s professional quality should be the main measure to carry through Prescription Administration Policy.