移动查房系统对临床药学工作的影响

目的 探讨移动查房系统对临床药学工作的影响.方法 比较新疆维吾尔自治区克拉玛依市中心医院使用移动查房系统前（1409例,2011年4月至2012年9月）及使用移动查房系统后（2 595例,2012年10月至2014年3月）临床药学工作数量、内容的变化,分析移动查房系统的技术优势及对临床药学工作的影响.结果 使用移动查房系统前不良反应、药物咨询、患者用药教育、医嘱审核与不合理医嘱干预数量分别为58、336、165、828、22例,使用移动查房系统后不良反应、药物咨询、患者用药教育、医嘱审核与不合理医嘱干预数量分别为85、377、260、1735、138例,不良反应上报数量增加了46.6％,患者用药教育增加了57.6％,医嘱审核工作量增长了109％,临床药师对不合理医嘱的干预数量增长了527％.临床药师在使用移动查房系统前干预不合理医嘱22例,主要为用法用量错误（11例,50.0％）、重复用药（3例,13.6％）、特殊人群用药禁忌（3例,13.6％）、相互作用（3例,13.6％）等方面;使用移动查房系统后干预不合理医嘱共计138例,主要为用法用量错误（66例,47.8％）、静脉营养液浓度过高（25例,18.1％）、重复用药（10例,7.2％）、特殊人群用药禁忌（12例,8.7％）、相互作用（8例,5.8％）方面.结论 移动查房系统使得临床药师的工作流程优化,工作效率提高,工作内容发生了根本改变,更多地参与科室内的会诊、临床药物治疗方案的设计.

Influence of mobile ward-round system on clinical pharmacy work

Objective To investigate the influence of mobile ward-round system on clinical pharmacy work.Methods Number of clinical pharmacy and contentbefore （1 409 cases,April 2011 to September 2012） and after using mobile rounds system （2 595 cases,October 2012 to March 2014） were compared.Technical advantages of mobile rounds system and its impact on clinical pharmacy were analyzed.Results The numbers of adverse drug reaction/drug consultation/medication education,audits on medical orders and interventions in irrational orders were 58,336,165,828,22 before using iPad.After using iPad,the numbers were 85,377,260,1 735,138 ; the adverse drug reaction increased by 46.6% ; the number of medication education in patients increased by 57.6%.The number of audits on medical orders was doubled （109%） ; the number of interventions on irrational medical orders increased five times（527%）.There were 22 cases ofirrational medical orders before using iPad.Among them,usage and dosage error was 50.0% （11/22） ; repeated medication was 13.6% （3/22） ; contraindication for special patients was 13.6% （3/22） ; drug interaction was 13.6% （3/22）.There were 138 cases ofirrational medical orders after using iPad.Among them,usage and dosage error was 47.8% （66/138） ; high concentration of intravenous nutrition liquid was 18.1% （25/138） ; repeated medication was 7.2% （10/138） ; contraindication for special patients was 8.7% （12/138） ; drug interactions was 5.8% （8/138）.Conclusion The mobile ward-round system not only makes clinical pharmacists workflow optimized,but also improves work efficiency.