某院静脉用药调配中心不合理医嘱干预情况研究

Study on the intervention of irrational medical orders in pharmacy intravenous admixture service in a hospital

目的通过回顾性探讨分析静脉用药调配中心(PIVAS)不合理医嘱原因,同时研究相应应对措施。方法回顾性分析2020年1—12月复旦大学附属中山医院厦门医院188份不合理用药医嘱相关医嘱信息,通过研究不合理类别,发现其存在相关规律。结果PIVAS常见不合理医嘱类型主要有给药浓度错误(25.00%)、载体选择错误(28.19%)、药物间配伍禁忌(23.94%)、给药频次错误(5.85%)、系统录入错误(17.02%)。不合理医嘱主要涉及药物品种有氯化钾注射液、复合磷酸氢钾注射液、多烯磷脂酰胆碱注射液、多种微量元素注射液(Ⅱ)、注射用头孢曲松钠等。不合理医嘱所属科室主要有普外科(23.94%)、肝肿瘤内科(20.21%)等。结论静脉用药调配中心作为全院成品输液集中调配场所,住院患者的用药安全应是每位药师首先应该关注的重点,PIVAS审方药师应通过不断的学习,丰富自身业务知识水平,保障临床、患者的用药安全,促进我院合理用药率的有效提升。

Objective To analyze the reasons of irrational medical orders in pharmacy intravenous admixture service(PIVAS)through retrospective discussion,and to study the corresponding countermeasures.Methods The irrational medical orders of 188 cases in Xiamen Branch of Zhongshan Hospital Affiliated to Fudan University from January 2020 to December 2020 was analyzed retrospectively.The relevant laws were found by studying the irrational categories.Results The main types of irrational medical orders in PIVAS were wrong drug concentration(25.00%),wrong carrier selection(28.19%),pharmaceutical incompatibility(23.94%),wrong drug frequency(5.85%)and wrong system entry(17.02%).Irrational medical orders mainly involved potassium chloride injection,compound potassium hydrogen phosphate injection,polyene phosphatidylcholine injection,multi-trace elements injection(Ⅱ),ceftriaxone sodium for injection,etc.The departments to which irrational medical orders belonged mainly included the department of general surgery(23.94%)and department of liver oncology(20.21%).Conclusion PIVAS is the centralized dispensing place of finished products for infusion in the whole hospital,and all pharmacists should pay attention to the medication safety of inpatients.The prescription-checking pharmacists in PIVAS should enrich their professional knowledge through continuous learning,ensure the medication safety of patients in clinic,and effectively promote the rate of rational drug use in our hospital.