刘威,黎颖然,李运景
LIU Wei,LI Yingran,LI Yunjing

• 1:中山市人民医院临床药学科

摘要(Abstract)：

目的探索临床药师审核医嘱、优化药物治疗方案的方法和作用。方法临床药师结合每日查房对2014-06~2015-06所在病区医嘱进行审核,发现需优化医嘱并提出建议,填写医嘱审核登记表,根据登记表对建议进行汇总分析。结果临床药师建议优化治疗医嘱191条,采纳率为93.72%。涉及药品品种主要为抗菌药物、循环系统药物和内分泌系统药物等;建议的内容主要为品种选择、用法用量、适应证及禁忌症等方面。结论临床药师通过开展医嘱审核,可有效优化用药方案、降低用药风险,促进了临床合理用药水平的提高。
OBJECTIVE To explore the methods and the role of clinical pharmacists in the medical order intervention.METHODS Clinical pharmacist found questionable medical orders in ward,then gave medication recommendations and filled in the registration form which were analyzed finally. RESULTS Clinical pharmacist proposed to optimize 191 advices,the adoption rate was 93.72%. Categories of involving drugs were mainly anti-microbial drugs,circulatory drugs,endocrine system drugs. Content of the proposals were mainly optima drug selection,drug delivery methods,drug indication and contraindication,etc. CONCLUSION By assisting physicians to adjust medical order,clinical pharmacists can improve the efficacy and safety of drug treatment.

关键词(KeyWords)： 临床药师;医嘱;干预
clinical pharmacist;medical order;intervention

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘威,黎颖然,李运景
LIU Wei,LI Yingran,LI Yunjing

参考文献(References)：

• [1]李成,孙强.促进合理用药的干预措施研究综述[J].中国卫生政策研究,2012,5(10):10-15.
• [2]陈集志,张增珠,李刚,等.临床药师对外科565次住院医嘱干预分析[J].中国药师,2012,15(7):1021-1023.
• [3]李萌,龚虹云,雷嘉川,等.抗肿瘤药物专业临床药师查房工作模式的探讨[J].中国医院药学杂志,2014,34(23):2048-2052.
• [4]Wheeler DC,Becker GJ.Summary of KDIGO guideline.What do we really know about management of blood pressure in patients with chronic kidney disease[J]?Kidney Int,2013,83(3):377-383.
• [5]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(7):579-616.
• [6]桑福德.热病(桑福德抗微生物治疗指南新译第44版)[M].北京:中国协和医科大学出版社,2014:212.
• [7]中国医师协会内分泌代谢科医师分会.2型糖尿病合并慢性肾脏病患者口服降糖药用药原则中国专家共识[J].中国糖尿病杂志,2013,21(10):865-870.
• [8]齐晓涟,唐静,白向荣,等.临床药师审查医嘱的结果分析[J].中国药师,2014,17(2):280-282.
• [9]王菡茵,曾睿,马佳,等.本院病历中不合理用药情况分析[J].中国药房,2013,24(2):103-105.
• [10]吴永佩,颜青.药学部门和药师是医院医疗工作四大核心技术支撑系统之一[J].中国医院,2014,18(1):59-61.