北京市某儿童医院近三年门诊输液不合理处方的调查分析

Irrational Outpatient Infusion Prescriptions in a Children's Hospital in Beijing in Recent Three Years

目的分析首都医科大学附属北京儿童医院近三年门诊输液不合理处方,为保证儿童用药安全提供参考。方法回顾性分析首都医科大学附属北京儿童医院2016-01-01—2018-10-30上报合理用药国际网络(INRUD)中国中心组临床安全用药监测网的556份门诊输液不合理处方,并分析引入普华合理用药软件审核处方前后半年给药剂量不适宜、溶媒选择不适宜、药液稀释浓度不当处方所占比例。结果 556份门诊输液不合理处方中适应证不适宜32份(占5.7%)、给药剂量不适宜323份(占58.1%)、溶媒选择不适宜49份(占8.8%)、药液稀释浓度不当130份(占23.4%)、配伍禁忌20份(占3.6%)、遴选药品不适宜2份(占0.4%)。引入普华合理用药软件审核处方前半年给药剂量不适宜、溶媒选择不适宜、药液稀释浓度不当处方共144份,引入该软件后半年上述3种门诊输液不合理处方共93份。结论首都医科大学附属北京儿童医院近三年门诊输液不合理处方以给药剂量不适宜、药液稀释浓度不当、溶媒选择不适宜为主,引入普华合理用药软件审核处方有利于减少不合理处方,同时应充分发挥药师的作用以保证儿童用药安全。

Objective To analyze the irrational outpatient infusion prescriptions in Beijing Children's Hospital Affiliated to Capital Medical University in recent three years,so as to provide a reference for clinical rational and safe use of drugs in children.Methods A total of 556 irrational outpatient infusion prescriptions reported to China Central Group Clinical Safety Drug Use Monitoring Network of International Network for Rational Drug Use(INRUD)in Beijing Children's Hospital Affiliated to Capital Medical University were retrospectively analyzed from January 1,2016 to October 30,2018,and proportions of inappropriate dosage,choices of solvent and dilution concentration of drug solution half a year before and after the application of Puhua Rational Drug Use Software were also analyzed.Results Among the 556 irrational outpatient infusion prescriptions,32 were inappropriate indications(accounting for 5.7%),323 were irrational dosage(accounting for 58.1%),49 were inappropriate choices of solvent(accounting for 8.8%),130 were inappropriate dilution concentration of drug solution(accounting for 23.4%),20 were wrong compatibility(accounting for 3.6%)and 2 were inappropriate drug selection(accounting for 0.4%).There were 144 inappropriate outpatient infusion prescriptions(including inappropriate dosage,inappropriate choices of solvent and dilution concentration of drug solution)half a year before the application of Puhua Rational Drug Use Software,where 93 outpatient infusion prescriptions were irrational half a year after application Puhua Rational Drug Use Software.Conclusion Irrational outpatient infusion prescriptions in Beijing Children's Hospital Affiliated to Capital Medical University in recent three years are mainly inappropriate dosage,inappropriate dilution concentration of drug solution and inappropriate choices of solvent,application of Puhua Rational Drug Use Software is helpful to reduce the irrational outpatient infusion prescriptions,and we should give full play to pharmacists to improve the level of rational drug use in children.