某院门/急诊药房不合理处方原因分析及干预效果探讨

Reason Analysis and Intervention Effects of Irrational Prescriptions in Outpatient/Emergency Pharmacies of a Hospital

目的促进临床合理用药,保障患者用药安全。方法利用医院信息系统调取某院2021年全年门/急诊药房处方数据,按是否对不合理处方进行事中干预分为干预前(2021年1月至6月)处方和干预后(2021年7月至12月)处方。干预前不合理处方数按临床科室统计并排序,筛选排名前3的科室为目标科室,其不合理处方类别按数量排序,采用帕累托图分析不合理处方的主要类型;采用鱼骨图分析不合理处方产生原因并进行针对性干预。比较干预前后的目标科室不合理处方发生率及干预成功率。结果目标科室为乳腺中心、血液内科、急诊科。不合理处方的主要不合理类型为适应证及用法用量不适宜,次要不合理类型为药品剂量、数量、单位等书写不规范。干预后不合理处方发生率为6.27%,明显低于干预前的9.42%(P<0.01);不合理处方干预成功率为94.23%,明显低于干预前的63.52%(P<0.01)。结论依据不合理处方产生的主要原因积极采取有效干预措施,有助于进一步提高处方质量及临床合理用药水平,保障用药安全。

Objective promote the rational drug use in clinical practice,and t Methods The prescriptions of the outpatient/emergency pharmacies in the hospital information system in 2021 were collected and divided into the pre-intervention(January to June 2021)prescriptions and post-intervention(July to December 2021)prescriptions according to whether the irrational prescriptions were intervened.The quantity of irrational pre-intervention prescriptions was counted and sorted by clinical departments.The top three departments were screened as the target departments,and the types of irrationality were sorted by the quantity of prescriptions.The Pareto chart was used to analyze the main types of irrationality of prescriptions.The fishbone diagram was used to analyze the reasons for irrationality of prescriptions,and the targeted intervention measures were taken.The incidence of irrational prescriptions and the success rate of intervention in the target departments before and after the intervention were compared.Results The target departments were the breast center,hematology department and emergency department.The main types of irrationality were inappropriate indications,inappropriate usage and dosage,the secondary types were non-standard writing of drug dosage,quantity,unit and so on.The incidence of irrational prescriptions after the intervention was 6.27%,which was significantly lower than 9.42%before the intervention(P<0.01).The success rate of intervention for irrational prescription was 94.23%,which was significantly lower than 63.52%before the intervention(P<0.01).Conclusion Actively taking effective intervention measures based on the main reasons of irrationality can further improve the quality of prescriptions,promote the rational drug use in clinical practice,and ensure the medication safety.