2020年首都医科大学附属北京友谊医院全病区32512条中成药医嘱前置审核及干预分析

Analysis of Pre-Review and Intervention of 32512 Medical Orders of Chinese Patent Medicine in All Wards of Beijing Friendship Hospital,Capital Medical University in 2020

目的:了解首都医科大学附属北京友谊医院(以下简称“我院”)全病区中成药医嘱前置审核及干预情况,以减少临床错误用药和不必要的退药操作,保证临床用药安全。方法:对2020年我院全病区32512条中成药医嘱进行前置审核,对不合理医嘱进行汇总与分析。结果:2020年我院全病区32512条临床中成药摆药以及出院带药医嘱中,356条为错误医嘱(占1.09%),主要涉及骨科风湿病区、肿瘤病区和泌尿科病区等。356条中成药错误医嘱中,医嘱类型错误的医嘱共183条(占51.40%),主要表现为应开具取药医嘱而开具长期医嘱;超说明书用药医嘱共173条(占48.60%),包括单剂量超量、用药频次错误、取药医嘱总量超量以及出院带药超量,主要涉及麻仁软胶囊、感冒清热颗粒等药品。结论:临床中药师在保证临床用药安全方面发挥着重要的作用,而临床药师自身的专业水平有待提高。同时,应加强临床医师对中成药的剂型理解,提高临床医师对药品说明书的认知也是确保临床用药安全的重要举措。

OBJECTIVE:To investigate the pre-review and intervention of medical orders of Chinese patent medicine in all wards of Beijing Friendship Hospital,Capital Medical University(hereinafter referred to as“our hospital”),so as to reduce clinical medication errors and unnecessary drug repercussion and ensure the safety of clinical medication.METHODS:In 2020,totally 32512 medical orders of Chinese patent medicine were pre-reviewed in all wards of our hospital,and irrational medical orders were summarized and analyzed.RESULTS:In 2020,of the 32512 medical orders of inpatient ward medication and discharge medication in our hospital,356 were wrong medical orders(1.09%),mainly for orthopedic rheumatism wards,tumor wards and urology wards.Among the 356 wrong medical orders of Chinese patent medicine,there were 183 wrong medical orders(51.40%),which were mainly manifested as long-term medical orders;there were 173 medical orders for off-label drug use(48.60%),including off-label single dose,wrong medication frequency,off-label dose of the total number of medical orders and off-label dose of discharge medication,mainly involving drugs such as Maren soft capsules and Ganmao Qingre granules.CONCLUSIONS:Clinical pharmacists play an important role in ensuring the safety of clinical medication,while the professional level of clinical pharmacists themselves needs to be improved.Meanwhile,clinicians should strengthen the understanding of Chinese patent medicine dosage form,and the improvement of cognition for clinicians to drug instructions is an important measure to ensure the safety of clinical drug use.