前置审方在涟水人民医院临床合理用药的实践与思考

Practice and Consideration of Prescription Pre-checking in Clinical Rational Drug Use of Lianshui County People's Hospital

目的:观察开展前置审方对南京医科大学康达学院附属涟水人民医院临床合理用药的影响。方法:选取2019年6-8月南京医科大学康达学院附属涟水人民医院开展前置审方的肿瘤科住院患者97129条医嘱为观察对象,观察采用前置审方系统干预的住院医嘱合格率、药师干预率、干预有效率和不合理医嘱类别变化。结果:2019年6、7、8月住院医嘱合格率、药师干预率和干预有效率逐渐提高,差异有统计学意义(P=0.001);医院超适应证用药、超剂量给药均减少,差异有统计学意义(P<0.05)。结论:前置审方对临床合理用药有促进作用,能够显著提高药师的审方效率,规范医师的诊疗行为,促进医院临床药物的合理使用,保障患者的用药权益。

Objective:To observe the impact of prescription pre-checking on clinical rational drug use in Lianshui County People's Hospital,Affiliated Hospital of Kangda College,Nanjing Medical University.Methods:A total of 97129 medical orders of the inpatients in the Oncology Department of Lianshui County People's Hospital,Affiliated Hospital of Kangda College,Nanjing Medical University from June to August 2019 during the implementation of prescription pre-checking were selected as the observation subjects.The qualification rate of the inpatient medical orders,the pharmacist intervention rate,the intervention efficiency,and the changes in the types of irrational medical orders by using prescription pre-checking system were observed.Results:The qualification rate of inpatient medical orders,the intervention rate of pharmacists and the effective rate of intervention were gradually increased in June,July and August 2019,with a statistically significant difference(P=0.001).The occurrences of off-label drug use,overdose medication in the hospitals gradually decreased,and the differences were statistically significant(P<0.05).Conclusion:Prescription pre-checking can promote clinical rational drug use,significantly increase the efficiency of prescription check by pharmacists,standardize doctors'diagnosis and treatment behavior,improve the rational use of clinical drugs in the hospitals,and ensure the interests of patients'drug use.