我院儿童门急诊医师分级处方行为分析

Study on Hierarchical Prescription Behavior of Physicians in Department of Pediatric Outpatient and Emergency in Our Hospital

目的分析医院儿童门急诊医师分级处方行为,以促进临床合理用药。方法按分层随机抽样法回顾性分析医院2014年儿童门急诊处方7 062张,对初、中、副高、正高职称医师处方行为进行分级分析,包括处方情况及用药合理性。结果儿童急诊处方以初、中职医师为主,门诊主要为副高、正高级医师,抽查处方主要涉及呼吸疾病;处方平均用药品种数、处方平均金额、基本药物使用率均符合相关规定;初、中职医师静脉给药比例及抗菌药物使用率显著高于副高、正高级医师;不合理处方比例初职最高,正高最低,尤其是不规范处方多见;不规范处方比例初职最高,其次为中职;而不适宜处方则是中职和副高较高,正高职称医师处方行为更加严谨规范。结论要规范合理用药,需加强对初、中职医师的处方规范化书写培训管理,并对中职、副高级医师不适宜处方行为进行干预和沟通。

Objective To analyze the hierarchical prescription behavior of physicians in Department of Pediatric Outpatient and Emergency, in order to promote rational drug use in clinic. Methods According to the stratified random sampling method, 7062 prescriptions were selected from Department of Pediatric Outpatient and Emergency in our hospital in 2014 were retrospectively analyzed, the prescription behavior of physicians in primary title, middle title, vice senior title and senior title was analyzed, including prescription and rationality of medication. Results Pediatric emergency prescriptions were mainly for physicians with primary title and middle title, and the outpa-tient service prescriptions were mainly for physicians with vice senior title and senior title, the sample prescriptions were mainly for res-piratory disease. The average number of prescriptions varieties, the average amount of prescriptions, and the use rate of essential drugs were in line with the relevant provisions. The intravenous administration prescriptions and the usage rates of antibiotics from physicians with primary title and middle title were significantly higher than physicians with vice senior title and senior title. The rate of unreason-able prescriptions from physicians with primary title was the highest, and the lowest from high titles, especially non-standard prescrip-tions were more common. Similarly primary titles get the most non-standard prescriptions, with middle titles following. The rates of drug use inappropriate were higher from middle titles and vice senior titles. The prescription behavior of physicians with senior title was more standard. Conclusion In order to standardize the rational use of drugs, it is necessary to strengthen the training and management of standardized prescription writing for physicians with primary title and middle title, and the intervention and communication of inappropri-ate prescription behaviors among physicians with vice senior title and senior title.