我院病区药房退药情况调查及减少退药对策

目的 分析病区药房退药情况,并提出几点相应的对策。方法 对我院2019年1～6月份病区药房6474张退药单中的退药金额、退药科室、退药频次、退药原因进行统计分析。结果 2019年1～6月份退药总金额为1 528 102.01元,约占药品出库金额的1.40%;全院30个科室均有退药,退药总频次达6474次,退药频次前5位的科室依次为21区呼吸科(14.84%)、18区心血管内科一区(12.30%)、7区神经外科(11.23%)、20区心血管内科二区(10.83%)、13区心血管内科三区(6.58%);退药原因主要为患者出院(31.71%)、医嘱调整(27.57%)、药物不良反应(11.12%)、患者转科(8.03%)、护士医嘱录入错误(5.25%)、患者拒绝使用(4.80%)、药房无药(4.14%)、医生重复开具同类药品(3.82%)、患者死亡(3.55%)。结论 我院病区药房退药现象涉及临床各科室,退药金额较大,退药原因较多,医院应当高度警惕退药带来的药品安全隐患,加强对退药的管理,严格执行退药管理制度,加强全体医务人员的业务素质,减少不必要的退药事件发生,保障患者的用药安全。

Investigation of drug withdrawal in pharmacy in our hospital and countermeasures for reducing drug withdrawal

Objective To analyze the drug withdrawal of ward pharmacy and put forward some corresponding countermeasures.Methods The amount of drug withdrawals,the withdrawal departments,the frequency of withdrawals,and the reasons for withdrawals from 6474 withdrawal orders in the ward pharmacy of our hospital from January to June 2019 were statistically analyzed.Results From January to June 2019,the total amount of withdrawals was 1 152 810.01 yuan,accounting for about 1.40% of the amount of medicines out of the warehouse.All 30 departments of the hospital had withdrawals,and the total frequency of withdrawals reached 6474.The top 5 departments with the most frequent withdrawals were the 21-area respiratory department(14.84%),18-area cardiovascular medicine department ward 1(12.30%),7-area neurosurgery department(11.23%),20-area cardiovascular medicine department ward 2(10.83%),13-area cardiovascular medicine department ward 3(6.58%).The main reasons for drug withdrawal were the patient''s discharge(31.71%),medical order adjustment(27.57%),adverse drug reactions(11.12%),patient transfer(8.03%),and nurse''s medical order entry error(5.25%),the patient refusing to use(4.80%),no medicine in the pharmacy(4.14%),doctor repeatedly prescribing similar drugs(3.82%),and the patient''s death(3.55%).Conclusion The phenomenon of drug withdrawal in the pharmacy of our hospital''s wards involves various clinical departments.The amount of drug withdrawal is large,and there are many reasons for drug withdrawal.Our hospital should be highly vigilant about hidden drug safety risks caused by drug withdrawal,strengthen the management of drug withdrawal,strictly implement the drug withdrawal management system,strengthen the professional quality of all medical staff,reduce unnecessary drug withdrawal incidents,to ensure the safety of patients'' medication.