临床药师对我院鼻饲医嘱前置审核规则的干预效果分析

目的分析我院鼻饲医嘱的常见问题,评价临床药师对医嘱前置审核系统持续改进的作用。方法收集我院2019年1-2月鼻饲医嘱情况,分析不合理医嘱。临床药师改进医嘱审核系统,进行用药指导宣教。分析干预后(2019年3-4月)鼻饲医嘱的情况,对比临床药师干预前后的效果。结果临床药师干预前:1-2月鼻饲医嘱5 598条,不合理医嘱总条数462条(8.25%)。前置审核系统共生成318条提示,正确提示181条(占56.92%),医生接受136条。临床药师干预后:3-4月鼻饲医嘱6 530条,不合理医嘱228条(占3.49%),干预后不合理医嘱显著减少(P<0.01)。前置审核系统共生成190条提示,正确提示176条(占92.63%),其中医生接受171条(90.00%),干预后医生接受度显著提高(P<0.01)。结论临床药师通过改进医嘱前置审核系统,提高了系统审核能力以及医生对系统的依从性,促进临床合理用药。

Effect analysis of clinical pharmacists'intervention in pre-audit system of nasogas-tric gavage medication order in our hospital

Objective To analyze the common problems in medication of nasogastric gavage in our hospital,and evaluate the role of clinical pharmacists in the improvement for medication pre-audit system.Methods The data of nasogastric gavage before intervention(from January to February 2019)were collected and the improper medications were analyzed.Clinical pharmacists updated the medication pre-audit system and provided pharmaceutical care for naso-gastric gavage.The situation of nasogastric gavage after intervention(from March to April 2019)was compared with that before intervention.Results Before intervention,there were 5598 medical records of nasogastric gavage,with 462(8.25%)irrational records.Medication pre-audit system defined 318 tips,in which 181(56.92%)were correct,and 136(42.77%)tips were accepted by clinicians.After intervention,there were 6530 medical records of nasogastric ga-vage,with 228(3.49%)irrational records,which were lower than those before intervention(P<0.01).Medication pre-audit system defined 190 tips,in which 176(92.63%)were correct,and 171(90.00%)tips were accepted by cli-nicians,which were higher than those before intervention(P<0.01).Conclusion Clinical pharmacists improve the audit capability of medication pre-audit system and the compliance of clinicians to it by improving the system,and pro-mote clinical rational drug use.