我院胃肠外科静脉用药不合理医嘱的统计与分析

Analysis of Irrational Intravenous Medication in Gastrointestinal Surgery Department

目的提高审方准确性,促进临床合理用药,提高静脉用药的安全性、有效性、经济性。方法静配药师通过科伦PIVAS协同管理系统,完善自定义药品字典的审方规则,利用智能+人工相结合的审方模式配合多种干预方法促进临床合理用药。以胃肠外科为代表,回顾性统计2019年5月至2020年10月的普通用药医嘱,分阶段逐一分析,对不合理医嘱进行统计和归类,并就不合理性原因进行统计和分析。结果39447条医嘱中不合理医嘱共计2877份,占全部医嘱的7.29%,包括药品剂量超量,给药频次不当等几类。可以看出通过静配药师不间断的干预,医嘱不合理率整体呈下降趋势。结论静配药师在规范临床用药方面发挥了重要作用。静配药师借助智能化审方系统构建审方规则,提高医嘱审核准确度,加强与临床的沟通,规避用药风险,提高药学服务质量。

OBJECTIVE To raise the quality of prescription inspection and to promote the rational use of venous transfusion medicine,ultimately to improve the safety,efficacy and economics of the clinical treatment.METHODS A customized drug dictionary in Colleen PIVAS system was employed by the pharmacists to supplement and refine the prescription audit rules.An artificial plus intelligence strategy was used to build up the medical order checking pattern in our hospital,assisted by various interventions in the irrational prescriptions.Unreasonable admixture of intravenous medication data in Gastrointestinal Surgery department from May 2019 to October 2020 were collected,categorized and analyzed.RESULTS 2877 in the total 39447 medical orders were determined to be irrational(7.29%)for inappropriate usage and dosage,unsuitable solvent dosage,incompatibility,etc.With the efforts of the PIVAS pharmacists,irrational usage was declining.CONCLUSION Pharmacists play an important role in standardization of clinical infusion application.It is necessary to enhance the communication between pharmacists and clinicians to reduce the risks of drug use and improve the quality of pharmaceutical services.