某综合医院急诊处方用药情况调查及干预分析

Investigation and Intervention Analysis of Emergency Prescriptions in a General Hospital

目的:调查分析某综合性医院急诊处方用药情况,针对不合理用药问题进行干预并考察干预成效。方法:应用PDCA循环管理方法作为干预措施,通过医院信息管理系统回顾性调查该院急诊干预前期(2015年)、干预期(2016年)、干预后期(2017年)所有处方信息,对干预前后急诊处方用药情况进行统计分析。结果:通过有效干预,急诊合格处方比例上升,抗菌药物使用比例降至40%以下。药物处方总费用下降,每张处方平均费用、用药品种数、注射剂使用率均下降。急诊抗菌药物处方总费用、每张处方平均费用、联合用药处方数下降。急性上呼吸道感染使用抗菌药物的处方比例下降。喹诺酮类药物处方数下降,其中静脉给药处方数降低。抗菌药物给药途径总体分布在干预前后无明显变化。结论:通过合理运用医院电子信息系统,医院多部门联动采取合理有效的干预措施加强处方监管,可获得显著成效,有利于促进急诊合理用药。

Objective： Objective to investigate and analyze the situation of emergency prescriptions in a general hospital,and to intervene in the problem of irrational drug use and investigate the effectiveness. Methods： Through the hospital information management system,all the emergency prescription information of the early intervention（ 2015）,Intervention period（ 2016） and the late intervention（ 2017） were reviewed. The PDCA cycle management method was used as the intervention measure,and the medication of the emergency prescription before and after the intervention was statistically analyzed. Results： Through effective intervention,the proportion of qualified prescriptions in emergency department increased,and the proportion of antibiotics was reduced to less than 40%. The total cost of drug prescriptions decreased,and the average cost of each prescription,the average number of prescriptions per prescription,and the percentage of injections used decreased. The total cost of antibiotics prescription,the average cost of each prescription and the number of combined prescriptions decreased. The proportion of antibiotics used in acute upper respiratory tract infection decreased. The number of quinolones decreased,and the number of intravenous prescriptions decreased. There was no significant change in the overall distribution of antibiotics administration before and after intervention. Conclusion： Through rational use of hospital electronic information system,hospital multi department linkage to strengthen prescription supervision,take reasonable and effective intervention measures,can achieve significant results,conducive to the promotion of rational use of emergency medicine.