基于静脉用药调配中心不合理用药医嘱的溯源与干预

The Tracing and Clinical Intervention of Irrational Medication Orders Based on Intravenous Medication of the Pharmacy Intravenous Admixture Service

目的溯源回顾分析我院静脉用药调配中心(PIVAS)的不合理医嘱,为合理用药提供依据与参考。方法提取2020年度1~12月的PIVAS处方与审核医嘱共计1308295条,对医嘱审核中出现的不合理用药情况进行分析。结果2020年度PIVAS接收医嘱共计1308295条,不合理医嘱507条,占0.039%,包括用药剂量不当、溶媒选择不当、配伍不当、录入错误和给药方式错误等。其中溶媒选择不当有319例,在不合理用药医嘱中所占比例最高,为62.92%;其次为用药剂量不当和医嘱录入错误,分别为15.38%和11.64%。所涉及的科室几乎涵盖全院各科室,其中以干部保健科较多,占15.39%。其次为乳腺甲状腺外科和骨科,分别为11.24%和10.45%。结论药师对医嘱进行审核,可及时纠正用药中存在的不合理现象,提高临床合理用药的精准水平,保证患者用药安全。

Objective To retrospectively analyze the irrational medication orders of PIVAS in our hospital,and to provide basis and reference for clinical rational medication.Methods A total of 1308295 cases medical orders submitted to PIVAS from January 2020 to December 2020 were collected,the irrational medication orders were analyzed.Results The 1308295 medical orders in 2020 years,507 irrational medication orders accounted for 0.039%,including unsuitable choice of solvent,unsuitable dosage,incompatibility,unsuitable input of doctors orders,unsuitable route of administration,etc.Among them,unsuitable choice of solvent were 319 cases,accounting for the highest proportion(62.92%)in irrational medication orders,followed by unsuitable dosage and input error(15.38%and 11.64%).The departments involved almost cover all the departments of the hospital.The cadre health care department accounted for 15.39%,followed by breast and thyroid surgery department and orthopedics department,which accounted for 11.24%and 10.45%respectively.Conclusions Pharmacists review medical orders,so as to correct the unreasonable phenomenon in drug use,improve medication orders accuracy and patient medication safety.