审方药师持续修正合理用药规则系统对医嘱审核失误发生率的影响

Influence of Prescription-checking Pharmacist's Continuous Revision of Rational Drug Use Rules System on the Error Rate of Medical Order Review

关键词:  人机结合医嘱审核模式  持续修正规则系统  医嘱审核失误

Key words:  man-machine cooperation medical order audit mode  continuous revision of rational drug use rules system  error in medical order audit

摘要:

目的 了解浙江大学医学院附属第一医院药学部实施“审方药师结合合理用药软件”人机结合医嘱审核模式进行医嘱审核服务的现状，直观分析问题，促进临床合理用药。方法 纳入2020年1月—2020年12月浙江大学医学院附属第一医院审方药师基于合理用药软件干预的医嘱审核失误，并进行统计分析。结果 统计共计103件医嘱审核失误的主要原因包括录入错误未审出34件（占总数33.01%），浓度错误未审出15件（占总数14.56%），配伍错误未审出12件（占总数11.65%），重复医嘱未审出9件（占总数8.74%），剂量错误未审出9件（占总数8.74%），溶媒选择错误未审出9件（占总数8.74%），用药疗程错误未审出6件（占总数5.83%），给药途径错误未审出4件（占总数3.88%），输液配置容量问题未审出4件（占总数3.88%），频次错误未审出1件（占总数0.97%）。实行人机结合医嘱审核模式后，医嘱审核失误率从最高的0.466件/万件医嘱，降低至0.116件/万件医嘱。结论 建立“审方药师结合合理用药软件”的人机结合医嘱审核模式可以通过对合理用药规则不断的维护与修正，持续提升医嘱审核质量，促进医院合理用药工作的开展。

Abstract:

OBJECTIVE To evaluate the current situation of using "prescription pharmacist combined with rational drug use software" man-machine cooperation medical order audit mode in medical order audit in the pharmaceutical department of The First Affiliated Hospital of Zhejiang University School of Medicine, to analyze the problems intuitively and to promote the rational use of drugs in clinic. METHODS Statistical analysis of the errors in medical order audit which intervened by prescription pharmacist based on rational drug use software in The First Affiliated Hospital of Zhejiang University school of Medicine from January 2020 to December 2020. RESULTS The main reasons for the 103 errors in the medical order audit included 34 cases(33.01%) of input errors, 15 cases(14.56%) of concentration errors, 12 cases(11.65%) of compatibility errors, 9 cases(8.74%) of repeated medical orders, 9 cases(8.74%) of dose errors, 9 cases(8.74%) of solvent selection errors, 6 cases(5.83%) of medication course errors, 4 cases(3.88%) of route of administration errors, 4 cases (3.88%) of infusion configuration capacity problems and 1 case(0.97%) of medication frequency error. After practise of man-machine cooperation medical order audit mode, the error rate of medical order audit decreased from the highest of 0.466 to 0.116 pieces per 1 0000 orders. CONCLUSION The establishment of man-machine cooperation medical order audit mode which is prescription pharmacist combined with rational drug use software can continuous improve the quality of medical order audit significantly and promote the development of rational drug use in hospital.