某医院肠外营养医嘱合理性分析

Reasonable Analysis on the Medical Prescription of Parenteral Nutrition in a Hospital

目的回顾性分析某医院肠外营养(PN)用药医嘱,为进一步加强规范该医院PN的合理应用提供参考依据。方法通过该医院的信息系统(HIS)收集2022年9月~2023年2月接受肠外营养支持治疗的9191份PN用药医嘱,分析经审核拦截的存疑医嘱。结果在9191份医嘱中,出现拦截并经人工复核判定不合理医嘱共有386份,占4.20%;不合理用药医嘱类型及占比为:营养组分配比不合理236份(占61.1%)、电解质浓度不合理94份(占24.3%)、维生素使用不合理43份(占11.1%)、药物配伍不合理12份(占3.1%)和其他11份(占2.8%)。结论该医院PN用药医嘱设计基本合理,建议临床医师及药师应加强相关指南及专业知识的学习,实现肠外营养规范化与个体化,确保临床用药安全、有效、合理。

OBJECTIVE In a retrospective analysis of a hospital′s parenteral nutrition(PN)medication or⁃ders,a reference was provided for further strengthening the rational application of PN in the hospital.METHODS 9191 PN medication orders for receiving parenteral nutrition support therapy were collected from September 2022 to February 2023 by using the hospital′s information system(HIS),and doubtful medication orders that appear blocked were analyzed by reviewing.RESULTS Among the 9,191 medication orders,386 cases(4.20%)were intercepted and judged to be unreasonable by manually reviewing;the types and percentages of unreasonable medication orders were 236 cases(61.1%)with unreasonable nutrient group distribution ratios,94 cases(24.3%)with unreasonable electrolyte concentrations,43 cases(11.1%)with unreasonable vitamin use,12 cases(3.1%)with unreasonable drug combinations,and 11 cases (2. 8%) with others. CONCLUSION The design of PN medication prescriptionsin the hospital is basically reasonable,and it is suggested the clinicians and pharmacists should strengthen the studyof relevant guidelines and professional knowledge to realize the standardization and individualization of parenteral nu⁃trition and ensure the safe、effective and reasonable clinical use of medication.