HIS预设联合用药规则设计提高儿童用药合理性的评价

Evaluation of HIS Preset and Drug Rules Design on the Rational Drug Use in Children

目的分析儿科中药物的不合理应用情况,探讨医院信息系统(hospital information system,HIS)与合理用药规则器的联用在儿童用药合理性中的作用。方法通过逸曜合理用药系统对处方进行自动点评,发现药品的使用在用法用量、给药途径中存在不合理现象;然后利用HIS系统对常用药品的用法用量、给药途径进行预设;同时针对儿童用药的特殊性,在合理用药系统中进行儿童专用规则的设计。结果通过HIS预设,用法用量、给药途径的不合理率分别从改进前的7.16%和0.57%下降到5.04%和0.19%。儿童专用规则器设定后,用法用量和给药途径错误比例呈逐年下降趋势,分别从2014年的3.44%和0.29%下降为2016年的1.01%和0.02%,四级和五级警示比例也分别从2014年的2.83%和0.35%下降为2016年的1.07%和0.11%,从而有效提高了处方合格率。结论 HIS的预设对医师开具处方的合理性具有明显作用,儿童专属规则器的设定可进一步提高用药的合理性。儿童用药资源的整合和人工智能的开发将有助于提高儿童的合理用药水平。

OBJECTIVE To analyze the irrational drug use in children,and explore the roles of HIS presets combined with drug rules in the rational use of drugs in children.METHODS Through the automatic prescription screening by Yi Yao rational drug use system,the main problems were drug usage and the route of administration.Drug usage and administration routes were preset in HIS system.According to the particularity of children＇s medication,special rules were designed in the rational drug use system.RESULTS The proportion of irrational drug usage and wrong routes of administrations were declined after HIS presetting,which was from 7.16% and 0.57% to 5.04% and 0.19%,separately.The proportion of errors in the dosage and route of administration was decreased from 3.44% and 0.29% in 2014 to 1.01% and 0.02% in 2016 respectively,and the ratio of the fourth and fifth alerts also dropped from 2.83% and 0.35% in 2014 to 1.07% and 0.11% in 2016 respectively.Thus,the qualified rate of prescriptions was effectively improved through the designing of children＇s special rules.CONCLUSION The presetting of HIS has obvious effect on prescribing rationality of physician,and the designing of children＇s specific rules can further improve the rational drug use.Integration of children＇s drug use resources and the development of artificial intelligent could help to improve the rational use of drugs in children.