论文部分内容阅读
目的建立并应用抗肿瘤药物合理用药拦截系统,规范医师处方行为,提高处方质量,促进临床安全合理用药。方法根据肿瘤医院用药特点,定向开发拦截系统并运行,搜集中山大学肿瘤防治中心的静脉调配中心、一体化药房2015年4月~2016年6月的处方及医嘱,按季度统计拦截系统截获不合理处方及医嘱占比、用药错误类型,比较拦截系统与既往合理用药软件审核性质及有效性。结果拦截系统运行后,不合理处方及医嘱比例显著下降,从2015年第二季度的8.1%降至2016年第二季度的1.9%,降幅达76.9%。截获用药错误类型主要表现在溶媒选择错误、调配浓度超限、剂量不当。与运行初期(2015年第二季度~2015年第三季度)比较,系统运行半年后(2015年第四季度~2016年第二季度)调配浓度不当的条目数从11 171条降至1 824条,降幅83.6%。截获溶媒剂量不当的条目数从626条降至372条,降幅40.6%。拦截系统的处方及医嘱审核前移,不合理处方及医嘱拦截有效率提高。结论应用拦截系统可智能、精准化服务于临床需求,提高审核效率,从源头上规范抗肿瘤用药处方及提高医嘱合理率,减少用药错误,促进药师提高临床药学服务水平。
Objective To establish and apply a reasonable drug interception system for anticancer drugs, standardize the prescription behavior of doctors, improve the quality of prescriptions, and promote the rational use of drugs in clinical practice. Methods According to the characteristics of the cancer hospital, the interception system was developed and operated to collect the prescriptions and medical orders from Sun Yat-sen University Cancer Center and the integrated pharmacy from April 2015 to June 2016, The proportion of prescriptions and medical orders, the types of medication errors, and the nature and effectiveness of the interception system and the software used for rational drug administration in the past. Results As a result of the operation of the interception system, the proportion of inappropriate prescriptions and orders decreased significantly, from 8.1% in the second quarter of 2015 to 1.9% in the second quarter of 2016, a decrease of 76.9%. Interception of the main types of medication errors in the choice of solvent, deployment concentration exceeded, the dose is not appropriate. Compared with the initial period of operation (from the second quarter of 2015 to the third quarter of 2015), the number of improperly allocated items dropped from 11 171 to 1 824 in the first half of the year after the system operation (from the fourth quarter of 2015 to the second quarter of 2016) , A drop of 83.6%. The number of improperly intercepted solvents dropped from 626 to 372, a 40.6% drop. Interception system prescribing and medical advice audit move forward, unreasonable prescriptions and medical interception efficiency. Conclusion The application of interception system can intelligently and accurately serve the clinical needs and improve the efficiency of audits. From the source, we can standardize antitumor prescriptions and improve the reasonable rates of doctors’ orders, reduce medication errors and promote pharmacists to improve clinical pharmacy services.