门诊处方前置审核系统中重复用药模块审查规则的优化实践

Optimization practice of review rules for repeated drug use module in outpatient prescription preaudit system

目的对前置审方系统中重复用药模块审查规则进行优化,以提高审方系统的精细化,促进临床合理用药。方法2021年6月15日至6月30日通过对中国科学技术大学附属第一医院处方前置审核系统静默运行期间拦截到的重复用药医嘱进行人工审核,利用相关循证医学证据,并与临床医师沟通反馈,确定具有临床意义的重复用药规则保留拦截。结果该期间门急诊处方中,系统静默审核拦截到的西药处方中重复用药不合理使用问题共1692例,经人工重新审后,发现仅526例软件审核是正确的,有1166例(68.91%)重复用药问题为“假阳性”问题,属于符合临床诊疗指南或临床合理用药范围,药师予以取消审方系统拦截并降为937例橙灯提醒(55.38%)和229例蓝灯提醒(13.53%)。结论药师对处方审核软件基础规则库进行持续自主维护修订是提升门诊处方审核工作质量的有效方法。

Objective To optimize the refinement of review rules of repeated drug use modules in the preprescription review system to improve the refinement of the review system and promote rational drug use in the clinic.Methods By manually reviewing the repeated drug orders intercepted during the silent operation of the preprescription review system from June 15 to June 30,2021,and utilizing the relevant evidence-based medical evidence and communicating with clinicians to provide feedback,the clinically significant repeated drug rules were determined to be retained for interception.Results In the outpatient and emergency prescriptions during this period,the system silently audited and intercepted a total of 1692 cases of irrational use of repeated medication in Western medicine prescriptions.After manual reauditing,it was found that only 526 cases of software audits were correct,and 1166 cases(68.91%)of repeated drug problems were"false-positive"issues,which belonged to the scope of clinical diagnosis and treatment guidelines or clinically rational drug use.The pharmacists cancelled the prevention of the prescription review system and reduced it to 937 orange-light reminders(55.38%)and 229 blue-light reminders(13.53%).Conclusion Continuous autonomous maintenance and revision of the prescription review software base rule base by pharmacists is an effective method to improve the quality of the outpatient prescription review process.