某三甲医院人血白蛋白使用的干预前后研究

Rational use of albumin in a 3A hospital:an intervention study

目的通过对某三甲医院人血白蛋白使用的干预研究,发现存在的问题并进行跟踪管理,促进合理用药。方法利用临床药学管理系统(PASS)和药品微机管理系统(HIS),随机等间距抽取该院2015年3月人血白蛋白使用量最多的前10个科室共85例人血白蛋白处方,作为干预前资料,由药学人员进行初评,处方点评专家组终评,点评结果反馈给临床科室,并提出存在的问题及改进措施;随机抽取2015年6月相同的10个科室共71例人血白蛋白处方作为干预后资料,采用同样标准进行点评,比较干预前、后效果。结果干预前抽取的85例处方中,不合理处方为54例,不合理率为63.53%;干预后所抽取的71例处方中,不合理处方为39例,不合理率为54.93%,不合理处方的主要类型均为用药适应证不适宜、用法用量不适宜。干预前后相比,人血白蛋白使用的不合理率有所下降,但有部分科室不合理率仍较高。结论通过干预,该院人血白蛋白使用不合理率有所下降,但仍较严重,需重点加强对部分科室和部分人员的使用管理,加强合理使用的培训及宣传等干预措施,进一步促进合理用药。

Objective We undertook the intervention study of albumin in a 3A hospital to find out the problems and give feedback to promote the rational albumin use in clinic.Methods 85 albumin prescriptions in March 2015 were randomly selected in top ten de-partments by Hospital Information System （HIS） and PASS Pharm Assist （PASS） in a 3A hospital as data before intervention.Prelim-inary review was carried out by pharmacists followed by final evaluation given by experts.The results of prescription review, problems and improvement measures were fed back to these clinical departments.Albumin prescriptions in June 2015 in the same departments were randomly selected as data after intervention and evaluations were given in the same way.And then the effects were compared be-fore and after intervention.Results In 85 cases of prescriptions before intervention, the rational prescriptions accounted for 63.53%（54 cases） while in the 71 cases after intervention, the irrational prescriptions accounted for 54.93% （39 cases）.Irrational prescrip-tions were shown as： inappropriate indication, incorrect usage and dosage.The proportion of irrational prescriptions of albumin de-creased after intervention and the total cases also decreased.But unreasonable ratio was still high in some departments.Conclusions By intervention,the unreasonable rate of albumin prescriptions was decreased in this hospital,but still high.It is strongly recommen-ded to strengthen the management of albumin usage in some departments, and also carry out training and learning of the rational use of albumin.