临床药师对住院医嘱不合理用药情况分析和干预措施

Intervention and Analysis of 198 Cases of Irrational Drug Use For Inpatients by Clinical Pharmacists

目的分析住院医嘱不合理用药情况,探讨干预措施,促进合理用药水平的提高。方法临床药师通过医院信息系统对住院医嘱进行人工审核,统计2015年6月至2016年5月处方点评827例,其中198例不合理用药医嘱的科室分布、不合理用药类型、药物分类。结果不合理用药的前十位科室中,前五位为骨科、肝胆胃肠外科、五官科、普通胸外科、感染科,外科科室所占的比例较内科科室的比例更多;在不合理用药医嘱的类型中,超疗程用药所占比例超过1/4(26.8%),重复用药所占的比例也较高,为21.2%;而超适应证用药的比例为11.6%。不合理用药的药品分类中,改善血液循环类药物(主要为中药注射剂和中成药)为57次,所占比例最高(占28.8%)。抗感染药物次之,为30次(占15.2%)。结论临床药师需要提高与重点科室及医师在药学用药方面的交流学习,对重点药物应加强监管。以事前防控纠错为主、事后点评分析为辅,把技术和行政结合起来进行干预管理,促进合理用药水平持续改进。

Objective To investigate the intervention for irrational drug use for inpatients by clinical pharmacists,improve the level of rational drug use.Methods Clinical pharmacists in hospital doctor’s advice for hospital information system of artificial audit,statistics,198 cases of irrational medication orders,the department of distribution,the types of irrational drug use,drug classification.Results In the top 10 departments of do not rational drug use,the top five was orthopedics,liver and gallbladder surgery,facial features,General Department of thoracic surgery,infectious diseases,surgical department the proportion of the proportion of the internal medicine department more;In kind of unreasonable medication orders,super drug treatment accounted for 26.8%,repeated drug use the proportion is 21.2%,the proportion of super indications drugs is 11.6%.Do not rational drug use of drug category,improve blood circulation drugs is the highest proportion（57 times）,.Anti-infective drugs is 30 times.Conclusion Clinical pharmacists should strengthen communication with doctors and departments,focusing on prevention of irrational drug use,combining technological intervention and administrative intervention to promote rational drug use continuously.