某院实施静配医嘱审核服务的效果及成因分析

Effect evaluation and causal analysis of medication orders of PIVAS examination in a hospital

目的了解某院实施医嘱审核服务的效果,分析问题成因,促进临床合理用药,并为循证药学的研究提供参考依据。方法对我院静脉药物配置中心2016年11月~2017年3月审核发现的不合理用药医嘱进行统计分析,并随访后续不良事件发生情况。结果共审核医嘱69 046条,其中不合理用药医嘱1519条,包括溶媒选择不适宜、载体量不适宜、给药剂量不适宜、给药途径不适宜、配伍禁忌等,占总医嘱的2.20%。在追踪的230条不合理医嘱中,未发现不良事件发生。结论目前我院整体用药相对合理,但仍存在部分不合理用药现象,应进一步加强药师对医嘱的审核能力和干预力度,同时应深入对部分超说明书用药情况的合理性思考。

Objective To investigate the effectiveness of prescription checking, analyze the causes of problems and promote the rational medication in clinic, so as to provide references for the research of evidence-based pharmacy. Methods From November 2016 to March 2017, irrational drug use from pharmacy intravenous admixture service during the prescription checking were analyzed and the adverse events were followed up. Results A total of 1519 irrational medication orders, including improper solvent selection, inappropriate dosage and route of medication, incompatibility and so on, accounted for 2.2% in totally 69 046 medication orders. There was no adverse events occurred in 230 irrational medication orders. Conclusion The overall drug use in the hospital is relatively resonable, but some irrational drug use phenomenon still exist. It is necessary to further strengthen the apothecarys′ ability to review the medication orders and intervention should be further enforced. Meanwhile, partial off-label drug use should be deeply and rationally reflected.