某院住院药房不良退药原因分析及干预效果评价

Analysis on Causes for Adverse Drug Withdrawal in Some Hospital Pharmacy and Evaluation of Intervention Effect

目的:分析我院不良退药原因并进行干预,评价其效果,为临床合理用药提供参考。方法:分析2012年至2013年6月我院住院病人退药原因构成、退药种次、金额以及不良退药率等情况,结合退药现状制定并实施干预措施,考察干预后(2013年7月至2014年1月)的退药变化情况,评价干预效果。结果:进行干预后,退药呈逐月下降趋势,不良退药下降尤为明显,至2014年1月底,不良退药种次降至7.02%,说明干预措施科学有效,应当坚持。结论:除特殊情况外,临床医师应按照各病种临床路径用药,防止重复医嘱和过度医疗;护理人员应掌握各药物的规范名称和剂型规格,严格按照护理规范操作,减少不良退药;药师应掌握临床病人用药特点,在配药前严格执行查对制度,对不合理用药或可疑用药,及时通知临床,以减少不良退药事件发生,保证规范用药。

Objective： To analyze the causes for adverse drug withdrawal in our hospital and evaluate effects of intervention, so as to provide references for the rational clinical drug use. Methods： Causes, times, medication costs, and the rate of adverse drug withdrawal were analyzed among inpatients in our hospital during the whole year of 2010 and the first six months of 2013. Intervention measures were formulated according to the current situation of drug withdrawal and implemented. The changes in the situation of drug withdrawal after intervention（July 2013 – January 2014） were investigated and the effects of intervention were evaluated. Results： After the intervention, the rate of drug withdrawal was declined by month, particularly adverse drug withdrawal. By the end of January 2014, times of drug withdrawals were decreased to 7.02%, indicating that the intervention was scientific and effective and it should be persisted. Conclusion： Except for special situations, clinicians should use drugs according to the clinical pathway of each disease and avoid repeated orders and excessive medical care. Nursing staff should grasp the specification name and dosage form of the drugs and perform nursing care in strict accordance with the nursing operation standards so as to reduce adverse drug withdrawal. Pharmacists should master the characteristics of medication for clinical patients, strictly implement the check system before dispensing and report the situation of unreasonable drug use or suspected drug use to clinicians timely so as to reduce adverse drug withdrawal and ensure standard medication.