北京市某三级口腔医院医务人员合理用药现状调查分析

A questionnaire survey on status quo of rational medication use by medical workers in a tertiary dental hospital in Beijing

目的了解北京市某三级口腔医院医务人员对合理用药相关知识与行为的现状,为制定管理对策提供参考。方法结合医院实际,设计合理用药调查问卷,专业不同、调研侧重点不同,对该院病区医师、护士及药师等医务人员进行无记名调查。结果共发放问卷98份,有效回收率为92%(90/98)。药师得分最高,医师略高于护士。多数医务人员能经常阅读药品说明书,但对合理用药基本理论整体掌握不足。医、药师对抗菌药物的分级管理、适应证等掌握较好,但对预防性使用疗程掌握不够;护士对抗菌药物给药间隔执行不理想。医护人员的药学服务需求与药学人员目前能够提供的药学服务之间存在出入,医师、护士目前收到用药干预或建议的频次不多,希望通过面谈、电话、微信等更直接的方式获得个体化用药建议和指导;药师经常进行用药干预的比例不到一半,且多为滞后干预,内容上整体用药评价多、具体病例用药建议少。医、护、药师均表示需要加强合理用药培训、发挥临床药师作用、做好处方/病历用药点评。结论需要采取综合管理措施,对不同医务人员开展针对性培训和教育,充分发挥临床药师作用,点面结合、多方联动共同促进合理用药水平的提高。

Objective To investigate the status quo of knowledge and behavior about rational medication use among medical workers in a tertiary dental hospital in Beijing,so as to provide references for development of management strategies.Methods A questionnaire for rational medication use was designed to adapt for the actu-al situation in the study hospital.An anonymous survey was then conducted among ward medical workers(physi-cians,nurses and pharmacists)in relation to their professions and topics of interest.Results A total of 98 ques-tionnaires were distributed,and the effective response rate was 92%(90/98).The pharmacists scored highest,fol-lowed by the physicians who scored slightly higher than the nurses.Most medical workers were used to read the drug labels often,but did not have sufficient mastery of the overall basic knowledge of rational medication use.The physicians and pharmacists had good mastery of the hierarchical stewardship and indications of antibacterials,but had insufficient knowledge about the courses of prophylactic antibacterial therapy.The nurses were not always competent in observing the dosing intervals for antibacterials.There was a disparity in pharmacy service with re-gard to what the medical workers need and what the pharmacists could offer.In this survey,physicians and nurses reported low frequency of receivinga medication intervention or advice,and expected to obtain recommendations and guidance on individualized medication through more direct approches such as face-to-face conselling,phone calls,and WeChat.Less than half of the pharmacists reported that they offered medication interventions often,and if any,most were time-lagged,more often with comments on overall medication than with specific advice on indi-vidual cases.All of the physicians,nurses and pharmacists acknowledged the need to reinforce trainings on ratio-nal medication use,the role of clinical pharmacists,and comments for medication in prescriptions or medical charts.Conclusion Comprehensive management measures should be implemented towards targeted training and education for medical workers,full reinforcement of the role of clinical pharmacists,and all-round collaborations to promote improvementsin rational medication use.