我院高警示药品管理及风险控制

High-alert Drug Management and Risk Control in Our Hospital

目的:探索我院高警示药品管理模式,为医疗机构对该类药品的管理和使用提供参考。方法:按照中国药学会医院药学专业委员会《高警示药品推荐目录》(2019版)制订我院高警示药品目录及风险点,对全院医师、药师、护士进行相关培训与考核;以临床科室、药学部门的高警示药品管理和使用合格率为检查指标,比较优化前后高警示药品管理和使用的效果。结果:我院通过建立检查督导小组、药师宣教、信息化管理、处方审核及个体化给药、用药指导、处方点评及用药错误上报等措施对高警示药品进行风险控制和持续优化。与优化前比较,优化后临床科室高警示药品管理和使用合理率由37.3%提高至80.1%(P<0.01),药学部门高警示药品管理和使用合理率由59.2%提高至85.0%(P<0.01);但仍存在高警示药品账物不符、用药错误未全部及时上报、审方软件规则建立不完善、用药指导不充分、个体化给药药品品种较少等问题。结论:通过对高警示药品管理及优化,有效提高了我院临床科室及药学部门对该类药品的管理和使用水平。

OBJECTIVE:To explore high-alert drug management mode of our hospital,and to provide reference for the management and utilization of this category in medical institutions.METHODS:According to High-alert Drug Catalog(2019 edition)issued by Hospital Pharmacy Committee of Chinese Pharmaceutical Association,the high-alert drug catalog of our hospital and their risk points were formulated.Relevant training and assessment were conducted for physicians,pharmacists and nurses throughout the hospital.Using qualification rate of high-alert drug management and utilization as index,the effectiveness of high-alert drug management and utilization were compared before and after optimization.RESULTS:In our hospital,the risk of high-alert drugs was controlled by establishing inspection and supervision group,pharmacist education,information management,prescription review and individualized administration,medication guidance,prescription review and medication error reporting and other measures and with continuous optimization.Compared with before optimization,qulification rate of high-alert drug management and utilization increased from 37.3%to 80.1%in clinical departments(P<0.01),and that increased from 59.2%to 85.0%in pharmacy department(P<0.01).There were still some problems,such as the inconsistency of high-alert drugs accounts and materials,the failure to report all medication errors in time,the imperfect establishment of prescription review software rules,the insufficient medication guidance,and the lack of individual medication varieties.CONCLUSIONS:By optimizing the management of high-alert drugs,the management and utlization of this category is improved effectively in clinical departments and pharmacy departments of our hospital.