某综合医院5856张门急诊处方用药分析

Analysis of 5 856 prescriptions issued at outpatient and emergency departments in a general hospital

目的:分析医院门急诊处方书写质量和不合理用药情况,以提高医院处方书写质量,促进合理用药。方法:抽查2014年1月-12月南方医科大学第五附属医院门急诊处方5 856张,采用逐张审查方式审核,从书写规范性及用药合理性角度,判断不合理处方并进行归类分析。结果 :5 856张门急诊处方中,不合理处方率为7.85%(460/5 856),门诊共选取4 051张处方,其中不合理处方率为6.44%(261/4 051),急诊共选取1 805张处方,其中不合理处方率为11.02%(199/1 805),门诊与急诊不合理处方率比较差异无统计学意义(P>0.05);门急诊不合理处方主要表现为书写不合格、溶媒选用不合理、用药方法不合理、药物选择不合理、药物联合应用不合理、抗菌药物应用不当与重复用药,其中抗菌药物应用不当处方率明显高于其他不合理处方率,比较差异具有统计学意义(P<0.05)。结论 :我院门急诊处方尚存在较多书写不合格与不合理用药情况,药师应强化处方审核、调配与核对门急诊处方,及时发现和纠正不合理用药,保证患者用药安全、经济、有效。

Objective： To analyze the writing quality of prescription issued at outpatient and emergency departments and irrational medication so as to improve the writing quality of prescription and promote rational medication.Methods： Five thousand eight hundred and fifty-six prescriptions in 2014 were randomly checked and examined one by one. The irrational prescriptions were classiifed and analyzed.Results： The irrational prescriptions accounted for 7.85% （460/5 856） in all 5 856 prescriptions and 6.44% （261/4 051） in total 4 051 outpatient prescriptions and 11.02% （199/1 805） in total 1 805 emergency prescriptions. The comparison of irrational prescriptions between outpatient and emergency departments showed no statistical signiifcance （P〉0.05）. The irrational prescription appeared mainly in unqualiifed writing, the selection of unqualiifed solvent, method for medication, selection and combination of drugs, the application of antibacterial agents and their repeated medication. The rate of irrational prescription in antibacterials was higher than the others （P〈0.05）.Conclusion： There still exist many unqualified writing of prescriptions and irrational medication in our hospital and pharmacists should strengthen the audit, deployment and check of the prescriptions at outpatient and emergency departments, timely ifnd and correct irrational medication so as to ensure the safe, economical and effective medication.