门诊处方及住院医嘱点评工作模式的实践

Practice of Review on Prescriptions and Medical Orders

目的:探索门诊处方及住院医嘱点评的合理工作模式。方法:通过建立我院门诊处方及住院医嘱点评制度和标准化操作流程,开展点评工作实践。结果:通过建立具有可操作性的多部门协作的门诊处方及住院医嘱点评工作体系,使医院的不合理处方及医嘱数量呈现持续下降趋势。结论:点评工作模式的实践使医院的信息化系统逐步完善升级,探索和建立起合理用药的长效工作机制,为医院合理用药管理提供了参考。

Objective： To explore the rational review on prescriptions and medical orders. Methods： Through establishing the rules and regulations, as well as laying down the SOPs in our hospital, the current working methods were summarized and the practice of review on prescriptions and medical orders was launched. Results： The cooperation of multi-departments was strengthened. The efficient system of review on prescriptions and medical orders was established. The irrational prescriptions and medical orders decreased and the rationality was improved in our hospital. Conclusion： The exploration and practice improved the hospital information system, set up a sustaining communication process, and consequently promoted the rational use of drug. It provided references for management of drugs.