儿科静脉用药调配中心退药原因分析及对策

Causes and countermeasures for drug return in pharmacy intravenous admixture services

目的对本院静脉用药调配中心的退药情况进行统计和分析,促进临床合理用药。方法对本院静脉用药调配中心2015年1-12月的所有退药记录进行统计和分析,同时对2015年1-5月与2016年1-5月的退药情况进行对比,结合退药单分析退药原因,提出持续改进措施。结果本院静脉用药调配中心2015年1-12月退药总金额为897 531.3元,总数量为16 162支,退药金额与退药数量最多的均为抗感染药物。退药原因主要有患者拒绝执行、不良反应、出院、手术取消、医嘱错误等。结论静脉用药调配中心退药原因分析可以反映临床用药过程中的用药合理性,应规范管理和退药流程,医师应合理用药,严格管理抗菌药物,加强与患者的沟通,提供个体化服务,从而减少退药。

Objective To analyze the causes for drug return in pharmacy intravenous admixture services （PIVAS） and to promote rational drug use. Methods We statistically analyzed all the records of the returned drugs in PIVAS in our hospital from January to December in 2015 and compared the difference between January to May 2015 with January to May 2016. Together with the drug return prescriptions, we analyzed the causes of drug return and proposed improvement measures. Results During 2015, the total value of drug return was 897 531.3 yuan in our hospital; the total item number was 16 162; anti-infection drug was the main contributior to the overall drug return value and quantity. The department of neurology and neurosurgery had the largest number of drug return. The main reasons included patients＇ as rejection to take drugs, adverse reactions, patient discharge, surgery canceled and prescription errors, etc. Conclusion Causes of drug return can reflect clinical medication rationality. We need standardized management of drug return, especially antimicrobial drugs, strengthen com- munication with patients, provide personalized service, so as to reduce the drug return.