我院老年病区PIVAS不合理医嘱及药师干预情况调查

Investigation on examination and intervention of irrational orders of PIVAS in geriatric department of our hospital

目的:调查我院老年病区药房审核PIVAS医嘱情况,以及对不合理医嘱进行干预的情况。方法:对我院老年病区药房2010年10月–2011年12月静脉药物配置中心297 335条医嘱进行实时审核,并对不合理或不合格医嘱通过电话告知和联络信沟通的方式进行干预,对审核结果和干预情况进行统计分析。结果:共审核出3256条不合理或不合格医嘱,占全部医嘱的1.1%,主要涉及配伍禁忌、药量-溶媒量不适宜、溶媒种类不适宜、加液量不适宜和营养袋标识不适宜5类问题,其中,干预成功878条医嘱,平均干预成功率为27.0%,不合理或不合格医嘱多出现于心血管内科。结论:通过医嘱审核,静脉用药医嘱得到了有效规范,药师在提高静脉用药合理性和适宜性、保障患者用药安全方面发挥了重要作用,但对临床特殊给药方案的审核和干预方法仍需进一步探索。

Objective： To investigate and analyze the examination and intervention of irrational orders of PIVAS in geriatric department of our hospital. Methods： A total of 297 335 orders of PIVAS collected from October 2010 to December 2011 were examined. The irrational and the unqualified orders were intervened by telephone and communication letters. Intervention on the audit results were analyzed. Results： Totally 3256 orders were unreasonable or unqualified, accounting for 1.1% of all orders, mainly related to incompatibility, the dose-solvent quantity, solvent species, inappropriate dosing, identification on the nutrition bag, etc. There were 878 successful intervention orders with an average success rate of 27.0%. Unreasonable or unqualified orders were mostly in cardiovascular medicines. Conclusion： The standard of the orders of PIVAS was promoted by the audit according to drug instructions. Pharmacists played an important role in improving the rationality and suitability of drug use and ensuring the safety of the patients. However, the audit and intervention methods for the special administration still need to be explored further.