某院静脉用药调配中心4389条不合理医嘱分析及改进措施探讨

Analysis of 4389 irrational prescriptions in pharmacy intravenous admixture services of a hospital and discussion on improvement measures

目的多角度、深层次分析本院PIVAS不合理医嘱情况,促进临床合理用药。方法对2019年3月-2022年2月PIVAS医嘱审核工作中的不合理医嘱进行回顾性分析。结果不合理医嘱共4389条,占0.097%。差错频次最多的不合理医嘱类型是溶媒错误,其次为操作错误。年差错率最高的是2020年;不合理医嘱发生率最高的是脑血管科;操作错误和溶媒量不合理频次最多的是10%氯化钾注射液;溶媒错误频次最多的是二羟丙茶碱注射液;配伍不合理频次最多的是地塞米松磷酸钠注射液;药物剂量不合理频次最多的是银杏二萜内酯葡胺注射液;发生差错最多的月份是12月。结论本研究进一步统计分析了本院PIVAS不合理医嘱情况,可为进一步提高本院合理用药水平作铺垫。

Objective To analyze irrational prescriptions in pharmacy intravenous admixture service(PIVAS)of our hospital from multiple angles and deep level,to promote clinical rational drug use.Methods Retrospectively analyzed irrational prescriptions from March 2019 to February 2022 in PIVAS prescription examination.Results There were 4389 irrational prescriptions,accounting for 0.097%.The type of irrational prescriptions with the most frequent errors was solvent error,followed by operation error.The highest annual error rate was in 2020.The highest incidence of irrational prescriptions was in the department of cerebrovascular.The most frequent operation errors and unreasonable solvent quantity were 10%potassium chloride injection.The most frequent solvent errors occurred in diprophylline injection.Dexamethasone sodium phosphate injection ranked first in incompatibility.Ginkgo diterpene lactone meglumine injection ranked the first in irrational drug dosage.The month with the most errors was December.Conclusions This study further analyzes the occurrence of irrational prescriptions in pharmacy intravenous admixture service of our hospital,which could pave the way for further improving the level of rational drug use in our hospital.