管饲合理用药的信息化前置审方规则库构建及效果分析

Establishment and Effect Analysis of Information-based Pre-review Rule Base for Rational Drug Use of Tube Feeding

关键词:  管饲给药  前置处方审核  合理用药

Key words:  tube feeding  pre-prescription review  rational drug use

摘要:

目的 构建管饲合理用药的信息化前置审方规则和合理用药知识库，评估其对不合理管饲用药医嘱的干预效果。方法 回顾性分析东南大学附属中大医院2021年1—8月住院患者管饲不合理用药医嘱，分析不宜管饲的药品种类、剂型，制定管饲合理用药审方规则，通过前置审方系统辅助审方药师人工干预不合理管饲医嘱，并对比干预前后的效果。结果 不合理管饲医嘱涉及药品剂型包括肠溶制剂、控缓释制剂、软胶囊或滴丸、注射剂，经审方系统和审方药师干预后，不合理管饲医嘱由干预前的5.59%显著降低至3.31%(P<0.001)。结论 通过构建合理管饲用药的前置审方规则库，干预不合理管饲医嘱的开具有利于帮助医师进行用药决策，减少用药错误的发生。

Abstract:

OBJECTIVE To construct pre-review rules and a knowledge base of rational drug use in tube feeding, and evaluate its intervention effect on irrational medical orders. METHODS The data of irrational medical orders in tube feeding from January to August 2021 in Zhongda Hospital Southeast University for inpatients were retrospectively collected and analyzed in terms of drug types and dosage forms which wasn’t suitable for tube feeding, and the review rule for rational drug use of tube feeding was set. The irrational medical orders were intervened by pre-review system cooperated with pharmacists, and the results were compared before and after the intervention. RESULTS The drug dosage forms of irrational medical orders involved enteric-coated preparations, controlled and sustained-release preparations, soft capsules or drop pills, injection. After the intervention by pre-review system and pharmacists, the irrational medical order base for rational drug use of tube feeding were significantly decreased from 5.59% to 3.31%(P<0.001). CONCLUSION The establishment of pre-review rule base for rational drug use of tube feeding and the intervention of the irrational medical orders contribute to make better medication decisions by physicians and reduce the occurrence of medication errors.