548份静脉用药集中调配中心常见不合理用药医嘱分析

Analysis on common irrational drug use in 548 medical orders from pharmacy intravenous admixture services

目的了解常熟市第一人民医院(以下简称"我院")静脉用药集中调配中心(PIVAS)不合理用药医嘱情况,为临床合理用药提供参考。方法收集我院2016年1月~2017年12月静脉用药集中调配中心审方药师干预的不合理用药医嘱记录,对不合理用药情况进行回顾性统计分析。结果 2016年1月~2017年12月PIVAS分别调配113.77万份和99.91万份医嘱,不合理用药医嘱分别为301份(0.0265%)和247份(0.0247%)。不合理用药医嘱以普外科、肿瘤科和急诊内科居多。不合理用药类型主要为溶媒种类选择不当(38.89%)、溶媒量使用不当(41.41%)和超剂量使用(7.91%)。消化系统用药不合理用药医嘱最多(17.34%),其次是维生素营养类药(12.77%)。结论药师利用PIVAS平台审核医嘱,可减少和避免不合理用药的发生,提高药物治疗的有效性和安全性,充分体现了药师的价值。

Objective To investigate the intervention on irrational medical orders in pharmacy intravenous admixture service（PIVAS） of Changshu NO.1 People′s Hospital（hereinafter referred to as ＂our hospital＂）, so as to provide reference for the rational drug use in clinic. Methods The irrational medical orders intervened by the prescription pharmacists of PIVAS were collected in our hospital from January 2016 to December 2017 and irrational drug use was retrospectively analyzed. Results From January 2016 to December 2017, the 1 137 700 and 999 100 medical orders in PIVAS each were configured. The irrational medical orders were 301（0.0265%） and 247（0.0247%）. In the department of general surgery, the oncology department and the emergency internal medicine, the number of irrational medical orders was more. The main types of irrational drug use were improper selection of solvent types（38.89%）, improper use of solvent（41.41%） and overdose use（7.91%）. Irrational medical orders in the digestive system were the most, followed by vitamin nutrients（12.77%）. Conclusion Pharmacists′ examination of medical orders in PIVAS can reduce and avoid the occurrence of irrational drug use, improve the effectiveness and safety of medical treatement. This can fully reflect the value of the pharmacists.