摘要
目的分析2019—2021年医院静脉用药调配中心不合理用药医嘱,为提高药师审方效率、减少临床不合理用药、确保患儿用药安全提供参考。方法回顾性分析福建省福州儿童医院静脉用药调配中心2019年1月至2021年12月665501组静脉用药医嘱,归纳不合理用药医嘱用药类型及药理分类,分析不合理用药医嘱产生的原因。结果不合理用药医嘱1630组,按不合理用药医嘱类型分类,共计7类,其中溶媒用量不适宜(25.71%)、溶媒选用不适宜(21.96%)、给药途径不适宜(19.57%)为主要因素,医嘱录入错误(14.91%)为次要因素,联合用药不适宜(8.77%)、给药剂量不适宜(8.53%)、重复给药(0.55%)为一般因素;按不合理用药医嘱药理分类,共计10类,消化系统药物(22.64%)、抗菌药物(22.58%)、血液系统药物(18.83%)为主要因素;电解质、维生素与营养药物(18.59%)为次要因素;内分泌系统药物(12.39%)、抗肿瘤药物(2.09%)、呼吸系统药物(1.41%)、护肝药(0.55%)、其他(0.49%)、循环系统药物(0.43%)为一般因素。结论使用帕累托图可快速、简单地分析不合理用药医嘱中的主要因素,为药师及时发现不合理用药医嘱提供便利并进行干预,从而减少临床不合理用药情况,提高患者的用药安全。
Objective To analyze the unreasonable medication orders in the hospital's pharmacy intravenous admixture services from 2019 to 2021,in order to provide reference for improving the efficiency of pharmacist review,reducing clinical unreasonable use of drugs and ensuring the safety of medication for children.Methods A retrospective analysis was conducted on 665501 intravenous medication orders from January 2019 to December 2021 at the Fuzhou Children's Hospital of Fujian Province.The types and pharmacological classification of unreasonable medication according to medical advice was summarized,the causes of unreasonable medication orders were analyzed.Results A total of 1630 unreasonable medication orders were identified and categorized into 7 types based on their characteristics.Among them,inappropriate solvent volume(25.71%),inappropriate solvent selection(21.96%),and inappropriate route of administration(19.57%)were the main factors leading to these medication orders.Prescription entry errors(14.91%)was identified as secondary factor,while inappropriate combination of drugs(8.77%),inappropriate dosage(8.53%),and repeated use of drugs(0.55%)were classified as general factors.The researchers also analyzed the pharmacological classification of the unreasonable medication orders,which revealed 10 categories in total.Digestive system drugs(22.64%),antimicrobial agents(22.58%)and blood system drugs(18.83%)were found to be the main factors leading to these medication orders.Electrolytes,vitamins,and nutritional drugs(18.59%)was identified as secondary factors,while endocrine system drugs(12.39%),anti-tumor drugs(2.09%),respiratory system drugs(1.41%),hepatoprotective drugs(0.55%),others(0.49%)and cardiovascular system drugs(0.43%)were classified as general factors.Conclusion The use of Pareto charts can provide a quick and simple analysis of the main factors contributing to unreasonable medication orders,making it easier for pharmacists to identify and intervene in such orders promptly.By doing so,pharmacists can reduce the incidence of clinical irrational medication practices and improve patient drug safety.
作者
张玲玲
王巍
邓本勇
ZHANG Lingling;WANG Wei;DENG Benyong(Department of Pharmacy,Fuzhou Children's Hospital of Fujian Province,Fuzhou 350000,China)
出处
《中国当代医药》
CAS
2023年第16期127-130,共4页
China Modern Medicine
关键词
静脉用药调配中心
不合理用药
医嘱
帕累托图
Pharmacy intravenous admixture service
Unreasonable medication
Physician's order
Pareto chart
