肾内科临床药师开展医嘱审核的思维模式初探

Preliminary Study on the Thinking Mode of Nephrology Clinical Pharmacists Reviewing Medical Orders

目的:探讨肾内科临床药师在病区开展医嘱审核的思路和方法,为促进肾内科合理用药提供参考。方法:结合肾内科具体案例,从审核治疗药物是否覆盖所有治疗问题、重复用药、药物选择、药物的用法用量与疗程、相互作用与配伍禁忌等方面,探讨肾内科临床药师开展医嘱审核的思路和方法。结果与结论:肾内科临床药师通过建立严密系统的医嘱审核的思维模式,结合自己的专业特长,可以梳理审核思路、弥补审核漏洞,提高临床药师参与临床实践的能力与水平。

OBJECTIVE ： To investigate the thoughts and ways of clinical pharmacist in nephrology department to review medical orders, and to provide reference for rational drug use in nephrology department. METHODS ： Based on specific cases of nephrology department, the thoughts and ways of clinical pharmacist in nephrology department to review medical orders were investigated from several aspects, including whether the therapeutic drugs had covered all the problems, drug duplication, drug selection, usage and dosage and course of treatments, drug interaction and compatibility. RESULTS ＆ CONCLUSIONS： By establishing rigorous and systematic review thinking mode, based on their professional specialty, clinical pharmacists of nephrology department can sort the reviewing thought, fill in the gaps of medical orders reviewing and enhance the ability of participating in the clinical practice.