基于处方前置审核系统的肠外营养审核与点评实践

Parenteral nutrition prescriptions audit and review based on a front-end audit system

目的通过优化肠外营养审核与点评模式,规范我院肠外营养处方,促进合理用药,降低医疗风险。方法分别调取我院开展处方前置审核前后接受肠外营养治疗的患者用药信息,综合点评,比较优化审核规则和审核模式前后肠外营养处方合格率。结果药师通过对处方前置审核系统规则库进行维护,使我院全肠外营养、补充性肠外营养处方整体不合理比例均有所下降,P值分别为0.03、0.03,差异有统计学意义。同时适应证不合理率(P=0.045)、营养素选择不合理率(P=0.045)、能量配比不合理率(P=0.03)、电解质浓度、给药途径、方案调整不合理率均显著降低,差异有统计学意义(P<0.05)。结论药师通过优化处方前置审核系统规则,可明显降低肠外营养处方不合格率,降低医疗风险。

Objective To rectify the parenteral nutrition prescribing in our hospital,promote rational drug use,and reduce medical risks by optimizing the practice of audit and review of parenteral nutrition prescriptions.Methods Medication data of patients on parenteral nutrition before and after the implementation of frond-end audit of prescriptions in our hospital were retrieved and subjected to comprehensive review.The qualification rates of parenteral nutrition prescriptions before and after audit rules and review mode optimization were compared.Results The pharmacist-initiated maintenance of the rules base in the front-end prescription audit system led to a reduction in overall irrational prescriptions of total(P=0.03)or supplementary(P=0.030)parenteral nutrition in our hospital with statistical differences.Significant reductions were also shown in irrationality of indicated prescriptions(P=0.045),nutrients selection(P=0.045),energy allocation ratio(P=0.03),electrolyte levels,administration routes,and protocol adjustment(P=0.03).Conclusion By optimizing the rules of the front-end prescription audit system,pharmacists can significantly reduce the unqualification rate of parenteral nutrition prescriptions and medical risks.