摘要
目的分析医院门急诊抗菌药物不合理处方的类型及原因。方法2018年8月-2019年7月期间,每月从全院门急诊抗菌药物处方数据中筛选出抗菌药物处方数排名前5的科室,在这5个科室中筛选出开具抗菌药物处方最多的医生各1名,随机抽取这5名医生各30张处方进行点评,每月共点评150张处方,连续点评12个月,共计1800张处方,发现不合理用药处方223张。涉及到的科室有呼吸内科、泌尿外科、急诊科、妇科、儿科、消化内科。结果不合理处方共7种类型,用帕累托图法分析不合理处方主要因素为联合用药不适宜、无适应证用药、用法用量不适宜;不合理处方次要因素为遴选药品不适宜;不合理处方一般因素为超疗程用药、重复用药、溶媒不适宜。结论根据影响不合理用药的主要类型、次要类型,对该类型的药物进行专项点评,并联合多部门制定切实有效的干预措施,保障患者用药安全、有效。
OBJECTIVE To analyze the types and causes of irrational antibiotic prescriptions in outpatients and emergency department.METHODS The top five departments in the number of antimicrobial prescriptions every month were selected during Aug 2018 and Jul 2019.And 30 prescriptions from each of the 5 doctors who prescribed the patients antibiotics most in each departments were randomly selected for comments.A total of 150 prescriptions were reviewed every month,and 1800 prescriptions were reviewed for 12 consecutive months,from which 223 irrational drug use prescriptions were found.The related departments involved respiratory medicine,urology,emergency department,gynecology,pediatrics,gastroenterology.RESULTS There were seven types of irrational prescriptions.The main factors of irrational prescription analyzed by Pareto diagram were unsuitable combination drug use,unindicated drug use,inappropriate usage and dosage.The secondary factors of irrational prescription were unsuitable drug selection,and the general factors of irrational prescription were over-course drug use,repeated administration and unsuitable menstruum.CONCLUSION According to the main and secondary factors of irrational drug use,special comments were made on these types of drug.Practical and effective intervention measures were formulated jointly with multiple departments to ensure the safety and effectiveness of drug use by patients.
作者
王丽华
姚梅芬
卢江燕
任文静
付桂英
WANG Li-hua;YAO Mei-fen;LU Jiang-yan;REN Wen-jing;FU Gui-ying(The Fifth Medical Centre,Southern District of Chinese PLA General Hospital,Beijing 100071,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第24期3817-3821,共5页
Chinese Journal of Nosocomiology
基金
北京市G20工程支撑保障项目(Z161100001816002)
关键词
帕累托图
门急诊抗菌药物
合理用药
Paretodiagram
Antibiotics of outpatient and emergency department
Rational drug use
作者简介
通讯作者:付桂英,E-mail:fuhaha12@163.com;王丽华(1974-),女,本科,副主任药师,研究方向:药学专业
