合理用药处方点评体系的构建及实施效果分析

Construction and Implementation Effect of the Rational Drug Prescription System

目的通过构建合理用药处方点评体系,提高处方点评质量,规范医疗行为,促进临床合理用药。方法以《医院处方点评管理规范(试行)》为指导,采取PASS临床药学管理系统软件与专业人员人工点评相结合的方式,通过完善处方点评标准、院内用药教育及行政干预等手段,优化处方点评流程及组织架构,构建一套科学、完善、可操作的处方点评体系。采取回顾性分析方法,抽取医院门急诊处方2012年67 566张,2013年76 833张,2014年86 579张;以《处方管理办法》《医院处方点评管理规范(试行)》《抗菌药物临床应用指导原则》以及药品说明书和相关文献为依据,对所抽查处方逐一审查,应用Excel 2013软件进行整理分析及评价。结果通过实施合理用药处方点评体系,可高效点评不合理处方,及时发现临床用药过程中的突出问题,落实行政管理手段,纠正不合理用药现状,提高处方合格率。实施该体系以来,处方合格率逐年上升,2012年、2013年、2014年分别为89.33%,96.30%,98.70%。结论通过处方点评、用药教育、行政干预等措施可显著提高处方合格率,持续改进不合理用药现象,规范医疗行为,确保医疗安全。

Objective To construct a reasonable prescription drug review system to improve the quality of prescription reviews, regulate medical practices, promote rational drug use. Methods The hospital prescription reviews Practices（ Trial） was used as a guide, the PASS clinical pharmacy management system software combining with professional reviews, and through means of improving the standard prescription reviews,hospital medicine education and administrative intervention,to optimize the prescription reviews processes and organizational structure, to build a scientific, perfect, actionable prescription review system. A retrospective analysis were taken from hospital outpatient and emergency prescription in the years of 2012,2013,2014,with prescriptions of 67 566,76 833,86 579 copies respectively; the relevant professional guidelines such as the Prescription Management,Hospital Prescription Reviews Practices（ Trial）,Clinical Use of Antibiotics Guidelines were used as the basis for the review,and the collated data were processed by Excel 2013. Results Through the implementation of rational drug prescription review system, it can efficiently review the irrational prescription, timely discover outstanding issues in the clinical drug process, implement the administrative instruments to correct the current situation irrational use of drugs and to improve the qualified prescription rate. Since the implementation of the system,the prescription- passing rate increased year by year to 89. 33%,96. 30%,and 98. 70% respectively. Conclusion Through the rational drug prescription review system,medication education,administrative intervention measures,it can significantly improve the passing- rate of prescription,continuously improve the irrational drug use,and standardized the medical practices,to ensure medical safety.