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本文主要分析常见门急诊静脉不合理医嘱并强调其药学干预作用。回顾性分析了2015年6月我院门急诊静脉药物配置中心(PIVAS)常见的不合理医嘱。于2015年7月起对门急诊静脉处方加强实施药师干预措施。采用系统抽样法以2016年1月抽取的930个病例医嘱作为干预组,2015年6月抽取的900个病例医嘱为对照组,比较加强干预前后两组总不合理率以及日平均不合理医嘱数。结果发现,门急诊静脉不合理医嘱主要包括为溶媒不合理、配伍不合理、给药途径不合理、给药剂量不合理和给药间隔不合理。对照组和干预组基线情况比较(包括性别和科别)无显著性差异(P>0.05),不合理率从17.4%降到3.3%(P<0.01),平均日不合理医嘱数从5.23±1.50下降到1.00±0.77(P<0.01)。从文中可以看出,药学干预可以降低我院医嘱不合理率,这对促进合理用药,提高医疗质量有重要意义。
This article mainly analyzes common emergency department venous unreasonable doctor’s advice and emphasizes its pharmaceutical intervention. Retrospective analysis of June 2015 my hospital emergency door intravenous drug allocation center (PIVAS) common unreasonable doctor’s advice. In July 2015, we strengthened the implementation of pharmacist interventions on outpatient and emergency department venous prescriptions. A total of 930 cases of medical orders drawn in January 2016 were selected as the intervention group by systematic sampling method. Nine hundred cases of medical orders collected in June 2015 were compared. The total unreasonable rates of the two groups before and after the intervention and the average number of unreasonable medical appointments . The results showed that the unreasonable doctor’s advice of emergency department mainly included unreasonable solvent, unreasonable compatibility, unreasonable route of administration, unreasonable dosage and irrational dose interval. There was no significant difference (P> 0.05) between the baseline and intervention groups (P> 0.05) and the unreasonable rate dropped from 17.4% to 3.3% (P <0.01) 1.50 to 1.00 ± 0.77 (P <0.01). It can be seen from the text that pharmacological intervention can reduce the unreasonable rate of doctor’s orders in our hospital, which is of great significance to promoting rational drug use and improving medical quality.