某院鼻饲给药情况及合理性调查分析

Current situation and rationality of nasogastric administration of medications in a hospital

目的调查住院患者鼻饲给药情况,进行合理用药分析,为促进临床鼻饲给药的合理性和规范性提供参考。方法采用回顾性分析方法,收集陕西省西安国际医学中心医院2021年1月至3月住院患者鼻饲给药医嘱信息,对鼻饲药物的使用情况及合理性进行统计分析,并针对不合理情况提出相应的改进措施。结果共有259例患者鼻饲给药,男女性比例为1.78∶1;使用位居前三的科室分别为神经外科重症监护室(ICU)、重症医学科、创伤ICU,其中涉及药物品种数135个,主要为心血管系统药物、肠内营养及电解质和消化系统药物。鼻饲剂型主要为普通片剂、口服液、普通胶囊和颗粒剂。不合理方面主要表现为药物的配伍不当及剂型选用不合理。结论医院鼻饲给药存在不合理情况,需进一步加强干预和管理,建议充分发挥临床药师和医嘱前置审核系统在合理用药方面的作用,为临床合理使用鼻饲药物提供强有力的支持。

Objective To investigate the current situation of nasogastric administration of medications,scrutinize the rationality of such practice among patients who stayed in a hospital,as to offer evidence for more proper and normative use of nasogastric medications in clinical settings.Methods Using a retrospective ap-proach,medical orders for nasogastric medications given to inpatients in Xi′an International Medical Center hos-pital prescribed between January and March of 2021 were retrieved.The use and rationality of the nasogastric medications were analyzed statistically.Measures to rectify any improper practicing were proposed accordingly.Results During the study period,there were 259 patients on nasogastric medications,with a male/female ratio of 1.78∶1.The first three units that predominated in the use of nasogastric medications,were the neurosurgery ICU,department of critical care medicine and the trauma ICU where 135 drug varieties were prescribed and chiefly involved medications for cardiovascular disorders,enteral nutrition,electrolyte correction and gastrointestinal dis-orders.The dosage forms in use frequently included non-sustained-release tablets,oral solutions,usual capsules and granules.The irrationality check noted improper drug compatibility and selection of pharmaceutical dosage forms.Conclusion In light of certain improper practicing with nasogastric administration of medications identi-fied in the surveyed hospital,there is a need for reinforcement of interventional and managerial measures that give full play to the roles of clinical pharmacists and pre-prescription audit system in observing rational drug steward-ship,so as to substantially endorse the proper use of nasogastric medications in clinical settings.