临床药师参与肿瘤内科全医嘱审核情况分析

Analysis of Participation of Clinical Pharmacists in Examination of General Medical Orders in Department of Oncology

关键词:  临床药师  肿瘤内科  全医嘱审核

Key words:  clinical pharmacist  department of oncology  general medical orders review

摘要:

目的 全面了解肿瘤内科医嘱情况，保证临床用药的合理安全。方法 临床药师对肿瘤内科实行全医嘱审核，并将2017年的审核情况进行总结分析。结果 2017年全年，临床药师共审核肿瘤内科医嘱16 754条，其中不合理医嘱201条，总不合理率为1.20%。第1季度、第2季度、第3季度和第4季度不合理率分别为1.62%，1.42%，0.95%和0.77%。不合理医嘱包括化疗药物预处理不适宜、给药频次不适宜、溶媒使用不适宜、给药时间不适宜、适应证不适宜、给药剂量不适宜、给药途径不适宜、重复用药及遴选药品不适宜等9种类型，占不合理医嘱总数的比例分别为17.4%，15.9%，15.4%，13.4%，11.9%，10.9%，9.0%，4.0%和2.0%。结论 2017年肿瘤内科医嘱不合理率按季度呈下降趋势，在一定程度上证实临床药师全医嘱审核和及时干预沟通对合理用药具有较好的作用。

Abstract:

OBJECTIVE To investigate the medical orders in department of oncology and to ensure the reasonable and safe use of clinical medicine. METHODS The clinical pharmacists condueted a full medical examination of the oncology department. and the court conditions in 2017 was summarized and analyzed. RESULTS In the whole year of 2017, the clinical pharmacists reviewed 16 754 medical orders, among which 201 were not reasonable, and the total irrational rate was 1.20%. In the first quarter, the second quarter, the third quarter and the fourth quarter, the irrational rate was 1.62%, 1.42%, 0.95% and 0.77% respectively. The irrationality manifested as irrational pretreatment of chemotherapy drug, irrational interval of drug administration, irrational dose or type of solvents, irrational drug administration time, inconformity between drugs and clinical diagnosis, improper drug dosage, irrational drug delivery route, repeated medication and irrational drug choice. The proportion of the total number of irrational orders were 17.4%, 15.9%, 15.4%, 13.4%, 11.9%, 10.9%, 9.0%, 4.0% and 2.0% respectively. CONCLUSION In 2017, the irrational rate of medical orders in department of oncology is gradually decreasing according to the quarter, and it may proves that the review of general medical orders and timely intervention of clinical pharmacists are effective for rational drug use.