责任药师在静脉药物配置中心不合理医嘱干预中的作用

Effects of Responsible Pharmacists on Irrational Medical Order Intervention in Pharmacy Intravenous Admixture Service

目的:探讨责任药师在静脉药物配置中心(PIVAS)不合理医嘱干预中的作用,促进临床合理用药。方法:回顾性分析我院PIVAS 2012年1-6月501 115份医嘱及建立责任药师制度并进行干预后的2013年7-12月499 189份医嘱,对不合理医嘱进行整理分类和归纳分析。结果:干预前不合理医嘱共918份(0.183 2%),干预后不合理医嘱下降为448份(0.089 7%)。其中,溶剂选择不合理医嘱由134份(0.026 7%)下降为69份(0.013 8%),溶剂体积不合理医嘱由435份(0.086 8%)下降为206份(0.041 3%),给药剂量不合理医嘱由241份(0.048 1%)下降为117份(0.023 4%),配伍不合理医嘱由51份(0.010 2%)下降为28份(0.005 6%),给药频次不合理医嘱由17份(0.003 4%)下降为2份(0.000 4%)。结论:责任药师干预静脉用药不合理医嘱效果明显,提高了临床合理用药水平,保障了患者用药安全。

OBJECTIVE：To probe the role of responsible pharmacist on irrational medical order intervention in Pharmacy Intravenous Admixture Service（PIVAS）,and to improve rational drug use in our hospital. METHODS：501 115 medical orders from PIVAS of our hospital during Jan.-Jun. 2012 were analyzed retrospectively. Irrational medical orders of 499 189 medical orders during Jul.-Dec. 2013 were classified and summarized after the establishment of responsible pharmacists system and pharmacist intervention. RESULTS：The number of irrational medical orders was 918（0.183 2%）,and decreased to 448（0.089 7%）after intervention. Irrational medical orders of solvent selection reduced from 134（0.026 7%）to 69（0.013 8%）;irrational medical orders of solvent volume reduced from 435（0.086 8%）to 206（0.041 3%）;irrational medical orders of drug dosage reduced from 241（0.0481%）to 117（0.023 4%）;irrational medical orders of drug compatibility reduced from 51（0.010 2%）to 28（0.005 6%）;irrational medical orders of dosing frequency reduced from 17（0.003 4%）to 2（0.000 4%）. CONCLUSIONS：What responsible pharmacists intervened in the irrational doctor＇s orders of intravenous drip was effective and feasible in PIVAS,improved rational drug use and guaranteed the safety of drug use.