静脉药物配置中心医嘱审核中抗肿瘤药物不合理医嘱的分析

Analysis of unreasonable doctor’s orders for antitumor drugs in the review of doctor’s orders of intravenous drug dispensing center

目的研究静脉药物配置中心医嘱审核中抗肿瘤药物不合理医嘱的情况。方法采用系统抽样方式选取我院医院信息系统中1000份静脉药物配置中心医嘱进行回顾性分析,并对静脉药物配置中心医嘱审核中抗肿瘤药物不合理医嘱的情况进行分析。结果在不合理医嘱类型中,溶媒选择不合理的不合理医嘱数量为39条,占39.00%;溶媒剂量不当的不合理医嘱数量为34条,占34.00%;药物数量和剂量不相符的不合理医嘱数量为22条,占22.00%;给药剂量不当的不合理医嘱数量为4条,占4.00%;超说明书用药的不合理医嘱数量为1条,占1.00%,各个类型相比较差异有统计学意义(P<0.05)。其中溶媒选择不合理情况最为常见;100张不合理医嘱中,单一用药、二药联用、三药联用、四药联用分别占抗菌药处方的50.00%、30.00%、20.00%、0,其中以单一用药处方最为常见。结论通过建立静脉药物配置中心,药师加强对抗肿瘤药物用药前医嘱审核,能够防止不合理医嘱所致的伤害,值得研究和推广。

Objective To study the unreasonable doctor’s orders for antitumor drugs in the review of doctor’s orders of intravenous drug dispensing center.Methods A systematic sampling method was used to select 1000 doctor’s orders of intravenous drug dispensing center from the hospital information system of our hospital for retrospective analysis,and the unreasonable doctor’s orders for antitumor drugs in the review of doctor’s orders of intravenous drug dispensing center were analyzed.Results Among the types of unreasonable doctor’s orders,there were 39 unreasonable doctor’s orders for unreasonable solvent selection,accounting for 39.00%;34 unreasonable doctor’s orders for improper solvent dose,accounting for 34.00%;22 unreasonable doctor’s orders for inconsistency between quantity and dose of drugs,accounting for 22.00%;4 unreasonable doctor’s orders for improper dosage,accounting for 4.00%;and 1 unreasonable doctor’s order for off-label drug use,accounting for 1.00%.There were statistically differences in different types(P<0.05).Among which,unreasonable solvent selection was the most common;among the 100 unreasonable doctor’s orders,single medication,combination of two drugs,combination of three drugs,and combination of four drugs accounted for 50.00%,30.00%,20.00%and 0 of the prescriptions for antibacterial agents,respectively,wherein single medication prescription was the most common.Conclusion Through the establishment of an intravenous drug dispensing center,pharmacists can strengthen the review of doctor’s orders before the use of antitumor drugs,which can prevent the harms caused by unreasonable doctor’s orders,and thus it is worthy of study and promotion.