魏雪,潘莹,李晓燕,梁蔚婷,陈卓佳,刘韬,黄红兵
WEI Xue,PAN Ying,LI Xiaoyan,LIANG Weiting,CHEN Zhuojia,LIU Tao,HUANG Hongbing

• 1:中山大学肿瘤防治中心药学部华南肿瘤学国家重点实验室肿瘤医学协同创新中心

摘要(Abstract)：

目的建立并应用抗肿瘤药物合理用药拦截系统,规范医师处方行为,提高处方质量,促进临床安全合理用药。方法根据肿瘤医院用药特点,定向开发拦截系统并运行,搜集中山大学肿瘤防治中心的静脉调配中心、一体化药房2015年4月~2016年6月的处方及医嘱,按季度统计拦截系统截获不合理处方及医嘱占比、用药错误类型,比较拦截系统与既往合理用药软件审核性质及有效性。结果拦截系统运行后,不合理处方及医嘱比例显著下降,从2015年第二季度的8.1%降至2016年第二季度的1.9%,降幅达76.9%。截获用药错误类型主要表现在溶媒选择错误、调配浓度超限、剂量不当。与运行初期(2015年第二季度~2015年第三季度)比较,系统运行半年后(2015年第四季度~2016年第二季度)调配浓度不当的条目数从11 171条降至1 824条,降幅83.6%。截获溶媒剂量不当的条目数从626条降至372条,降幅40.6%。拦截系统的处方及医嘱审核前移,不合理处方及医嘱拦截有效率提高。结论应用拦截系统可智能、精准化服务于临床需求,提高审核效率,从源头上规范抗肿瘤用药处方及提高医嘱合理率,减少用药错误,促进药师提高临床药学服务水平。
OBJECTIVE To establish and apply interception system,standardize the physician prescription behavior,improve the quality of prescription,and to promote clinical safety and rational use of drugs. METHODS According to the characteristics of drug use in cancer hospitals,the software of intercepting system was designed and operated. The prescriptions and orders from April 2015 to June 2016 were collected from Sun Yat-sen University Cancer Center. Interception system intercepted unreasonable medical orders by quarterly statistics. Accounting for the wrong type of medication,comparing the interception system with the previous rational use of drugs and audit the nature and effectiveness. RESULTS After the interception system was operated,the proportion of unreasonable medical advice decreased significantly,from 8.1% in the second quarter of 2015 to 1. 9% in the second quarter of 2016,a decrease of 76. 9%.Intercepted medication error types mainly in the selection of the wrong medium,the concentration of the preparation of overrun,the amount of liquid configuration improper. Compared with the beginning of the operation( the second quarter of 2015 to the third quarter of2015),the software running after six months( the fourth quarter of 2015 to the second quarter of 2016) the number of configuration of the concentration of inappropriate items from 11 171 to 1 824,down 83.6%. The number of interception of improper liquid solvent volume decreased from 626 to 372,down 40.6%. Interception system audit prescription forward,unreasonable medical advice to block the high efficiency. CONCLUSION Intercepting system is intelligent and precise to serve the clinical needs,improve the efficiency of examination,the prescription of antineoplastic prescriptions and the reasonable rate of medical advice,reduce medication errors,and promote pharmacists to improve the clinical pharmacy service level.

关键词(KeyWords)： 抗肿瘤药物;合理用药;网络信息环境
anticancer drugs;rational drug use;network information environment

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 魏雪,潘莹,李晓燕,梁蔚婷,陈卓佳,刘韬,黄红兵
WEI Xue,PAN Ying,LI Xiaoyan,LIANG Weiting,CHEN Zhuojia,LIU Tao,HUANG Hongbing

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