青海大学附属医院静脉药物配制中心不合理用药分析及药师干预效果研究

Analysis of Irrational Medication and Pharmacist Intervention Effect in Pharmacy Intravenous Admixture Service of Qinghai University Affiliated Hospital

目的:分析青海大学附属医院(简称我院)静脉药物配置中心(Pharmacy Intravenous Admixture Service,PIVAS)不合理用药及药师干预效果,促进合理用药。方法:采用回顾性分析方法,随机抽取我院2015年1月至6月(干预前)和2015年7月至12月(干预后)PIVAS的液体药物各4 000组,比较干预前后静脉药物不合理用药比例、不合理用药类型比例。同时随机抽取在院医师50例,于干预前后进行药物知识考核,并进行组间比较。结果:与干预前相比,干预后PIVAS不合理用药比例降低(1.1%vs 3.8%,P<0.05)。PIVAS常见不合理用药依次为用药频次不当、配伍禁忌、剂量不当、联合不当、溶媒不当及其他,且各不合理用药类型比例组间比较均无统计学差异(P>0.05)。药物知识考核情况显示,与药师干预前相比,干预后医师考核良好比例升高,考核差比例降低,组间比较都有统计学差异(P<0.05),而考核一般比例组间比较无统计学差异(P>0.05)。结论:我院PIVAS主要存在用药频次不当、配伍禁忌、剂量不当、联合不当、溶媒不当等不合理用药,药师干预可以有效减少不合理用药发生,促进医师掌握用药知识,临床上值得进一步探讨。

Objective. We aimed to analyze irrational medication and pharmacist intervention effect in pharmacy intravenous admixture service （PIVAS） of Qinghai University Affiliated Hospital in order to promote rational medication.Methods. In our study, we used retrospective analysis method to select 4 000 groups of liquid randomly in PIVAS of our hospital from January to June in 2015 （before intervention） and 4 000 groups of liquid from July to December in 2015 （after intervention） to compare the incidence of irra- tional medication and proportions of types of irrational medication. Meanwhile, 50 doctors in the hospital were randomly selected to examine their drug knowledge before and after pharmacist intervention.Results： In comparison with before intervention, incidence of irrational medication in PIVAS after intervention was statistically lower （1.1% vs. 3.8%, P〈0.05）. The common types of irrational medication in PIVAS were improper frequency of drug use, drug incompatibility, improper dose of drug, improper drug combination, improper selection of solvent and others in turn, and proportions of types of irrational medication before and after intervention were statistically same （P〈0.05）. Examination of drug knowledge presented that rate of well--examined was statistically higher and rate of poor--examined was statistically lower after in- tervention in comparison with those before intervention （P〈0.05）, while rates of ordinary--examined were statistically same （P〈0.05）. Conclusion： the PIVAS in our hospital mainly exists irrational medica- tion of the improper frequency of drug use, the drug incompatibility, the improper dose of drug, the im- proper drug combination, and the improper selection of solvent. Besides, pharmacist intervention can ef- fectively reduce incidence of irrational medication and promote doctors to master the drug knowledge.