药物咨询和用药安全监测系统拦截严重不合理用药-中国现代应用药学.PDFVIP

·药物警戒 · 药物咨询和用药安全监测系统拦截严重不合理用药的统计分析  * 周尔文，寿军，周权 (浙江大学附属第二医院，杭州 310009) 摘要：目的 估算综合药学干预前后医生在医嘱开立时第一时间的合理用药水平。方法 利用《药物咨询和用药安全监 测系统》( 即大医通软件)的后台工作站，导出严重不合理住院医嘱自动拦截、警示的记录，进行数据挖掘。药师在分析第 一阶段(2011 年7 月—2012 年6 月)相关数据后，采取培训、案例分析、制度修订和追踪检查等综合药学干预措施，并再 次分析第二阶段(2012 年7 月—2013 年2 月)的相应记录。结果 与第一阶段相比，第二阶段时期严重不合理住院医嘱警 示占所有住院医嘱的百分比显著降低(P0.05) 。因儿童禁用、给药途径禁用、用药超剂量和配伍禁忌问题发生的平均每月 软件拦截件数显著下降，下降幅度分别为 74.8% ，89.4%，66.7%和 16.6%。结论 综合药学干预措施可以潜移默化地降 低医生的不合理用药。医生在医嘱开立时第一时间的用药合理水平显著增加。 关键词：住院医嘱；软件；合理用药；药学干预；处方审核；处方筛选 中图分类号：R969.3 文献标志码：B 文章编号：1007-7693(2013)11-1261-03 Analysis of Severe Irrational Inpatient Medical Orders Intercepted by an Online Software * ZHOU Erwen, SHOU Jun, ZHOU Quan (The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China) ABSTRACT: OBJECTIVE To estimate the level of rational drug use when prescribing inpatient medical orders before and after comprehensive pharmaceutical interventions. METHODS Analysis was performed on all records on automatic warning of severe irrational medical orders from workstation of the software with function of prescription screening and warning during July 2011June 2012. Series of comprehensive pharmaceutical intervention measures were taken by pharmacists, including trainings, typical case analysis, revision of standard operation procedures and tracing method. Records during July 2012Feb 2013 were data mined again. RESULTS Compared with the first stage, proportion of severe irrational medical orders relative to all medical orders for inpatients decreased significantly(P0.05) and average number of cases related with pediatric contraindication, administration route contraindication