门诊妇产科处方前置审核规则精细化设置与实施效果评价

Fine setting and implementation outcome evaluation of pre-audit rules for outpatient obstetrics and gynecology prescriptions

目的建立门诊妇产科处方精细化审核规则库,提升处方前置审核系统的专科适用性。方法以处方前置审核软件基础数据库为依托,搜集精细化设置前门诊妇产科处方基于商业规则库的审核数据并进行分析,逐步对相关审核规则进行优化,形成具有妇产科专科特色的精细化审核规则库并实施。结果初步建立了妇产科超说明书用药、门诊抗菌药物管理等问题切实可行的解决方案。精细化设置前后,系统审核不合格率、药师审核率分别由45.82%、7.10%降至22.58%、4.82%;医生主动修改率、药师干预率、最终任务合格率分别由26.19%、41.01%、67.63%上升至63.59%、56.80%、95.03%。结论门诊妇产科处方精细化审核规则库的建立,对于处方前置审核工作的推进、处方审核工作质量的提升、药师工作效率的提高、医生开方效率的提升均是必要和有效的,为许昌市中心医院其他科室处方精细化审核工作奠定基础,也为其他医院相关建设提供思路及方法参考。

OBJECTIVE To establish a refined prescription audit rule base for obstetrics and gynecology(OB&GYN)to improve the specialized applicability of pre-prescription review system.METHODS With a basic database of prescription pre-audit software,the audit data of OB&GYN based upon commercial rule base before fine setting were collected.And the relevant audit rules were gradually optimized for forming a fine audit rule base with the characteristics of OB&GYN.RESULTS A feasible solution to the problems of off-label drug use in OB&GYN and outpatient antibiotics management was preliminarily established.Before and after refinement setting,unqualified rate of system audit and pharmacist audit rate declined from 45.82%and 7.10%to 22.58%and 4.82%respectively.Active physician modification rate,pharmacist intervention rate and final task qualification rate spiked from 26.19%,41.01%and 67.63%to 63.59%,56.80%and 95.03%.CONCLUSION The establishment of refined prescription audit rule base of OB&GYN is both feasible and effective for promoting pre-prescription audit,enhancing the quality of prescription audit and boosting the efficiencies of pharmacist work and physician prescription.It lays a solid foundation for refined prescription auditing of other departments and also provides references for other hospital-related constructions.