静脉药物调配中心审方质控优化后合理用药效果分析

Effect analysis of rational drug use after prescription checking and quality control optimization in pharmacy intravenous admixture services

目的分析静脉药物调配中心(PIVAS)审方质控优化后合理用药效果。方法于2021年1月至12月优化西北妇女儿童医院药剂科PIVAS审方质控工作,统计分析不合理医嘱情况以及医生、护士对PIVAS审方的满意度。结果不合理医嘱处方主要表现在浓度超说明书、剂量超说明书、溶媒不合适、配伍禁忌、用药频次错误、药物经济不合理等方面;各季度不合理医嘱发生率分别为0.50%、0.32%、0.08%、0.04%,第三、四季度的不合理医嘱发生率均低于第一、二季度,差异有统计学意义(P<0.001)。PIVAS审方质控优化实施后医生、护士对PIVAS药师审方能力、药师对不合理医嘱沟通方式等方面的满意度高于实施前,差异有统计学意义(P<0.05)。结论优化PIVAS审方质控工作的效果显著,能强化药师收集不合理医嘱管理,提高同质化审方,改善医生、护士与PIVAS药师之间的协作,降低不合理医嘱的发生率,值得推广应用。

Objective To analyze the effect of rational drug use after the optimization of the quality control of the prescriptions reviewed by the pharmacy intravenous admixture services(PIVAS).Methods From January to December 2021,the quality control of PIVAS review prescriptions in the Department of Pharmacy,Northwest Women's and Children's Hospital was optimized,and the situation of unreasonable medical orders and the satisfaction of doctors and nurses with PIVAS review prescriptions were statistically analyzed.Results Irrational doctor's orders were mainly manifested in the aspects of concentration off-label,dosage off-label,inappropriate solvent,incompatibility,wrong medication frequency,unreasonable drug economy,etc.The incidence of unreasonable medical orders in each quarter were 0.50%,0.32%,0.08%and 0.04%,respectively.The incidence of unreasonable medical orders in the third and fourth quarters were lower than those in the first and second quarters,and the differences were statistically significant(P<0.001).After the implementation of PIVAS prescription review quality control optimization,the satisfaction of doctors and nurses on the prescription review ability of PIVAS pharmacists and the communication mode of unreasonable medical orders were higher than those before the implementation,and the differences were statistically significant(P<0.05).Conclusion The effect of optimizing the quality control of PIVAS prescription review is significant;it can strengthen the management of pharmacists'collection of unreasonable medical orders,improve the homogenization of prescriptions,improve the cooperation between doctors,nurses and PIVAS pharmacists,and reduce the incidence of unreasonable medical orders.It is worth popularizing and applying.