摘要
目的基于Pareto定律分析甘肃省中医院门诊用药不合理情况及原因,探讨处方质量改进和干预方向。方法应用医院信息系统处方点评模块,随机抽取并评价2015年7月-2019年4月门诊处方,对3571条不合理处方按问题类型归类,采用SPSS22.0分析不合理处方主要因素、次要因素和一般因素。结果不合理处方情形共21项。主要因素3项:①用法用量不适宜;②开具处方未写临床诊断及中医证型或书写不全;③中药饮片处方药物未按照“君、臣、佐、使”的顺序排列,或未按要求标注药物调剂、煎煮等特殊要求。次要因素2项:①适应证不适宜;②无特殊情况下,门诊处方超过7 d用量,急诊处方超过3 d用量,慢性病、老年病或特殊情况下需要适当延长处方用量未注明理由。其他16项为一般因素。结论甘肃省中医院应对不合理处方的主要因素进行干预和追踪,加强监测次要因素,重视一般因素的影响,精准开展药学服务,督促合理用药,保障医疗安全。
Objective To analyze the irrational medication in outpatient of Gansu Provincial Hospital of TCM based on Pareto's law;To discuss the improvement of prescription quality and the direction of intervention.Methods Prescriptions in out-patient were randomly selected and evaluated from July 2015 to April 2019 using the prescription evaluation module of hospital information system.3571 irrational prescription records were classified according to the types of problems.The main factors,secondary factors and other factors of irrational prescription were analyzed by SPSS 22.0 software.Results There were 21 irrational prescription situations.Among them,3 irrational prescription situations were main factors including inappropriate dosage,the prescriptions without clinical diagnosis and TCM syndromes or incomplete information,and TCM decoction pieces not being arranged in the order of“principal,subordinate,adjuvent,and guide”or not being marked with special requirements according to dispensing and decocting.2 irrational prescription situations were secondary factors including inappropriate indications,the dosage of outpatient prescription exceeded 7 days or that of emergency prescription exceeded 3 days without special circumstances,or chronic disease,and geriatric disease or special circumstances needed to appropriately prolong the prescription dosage without specifying the reasons.Other 16 irrational prescription situations were other factors.Conclusion Gansu Provincial Hospital of TCM should intervene and track the main factors of irrational prescriptions,strengthen the monitoring of secondary factors and pay attention to the influence of other factors in order to carry out pharmaceutical services accurately,urge rational medication and ensure medical safety.
作者
张民
肖正国
豆金彦
刘军刚
王炯
胡君茹
李莉
安培坤
陈耀章
ZHANG Min;XIAO Zhengguo;DOU Jinyan;LIU Jungang;WANG Jiong;HU Junru;LI Li;AN Peikun;CHEN Yaozhang(Department of Pharmacy,Gansu Provincial Hospital of TCM,Lanzhou 730050,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2020年第6期127-130,共4页
Chinese Journal of Information on Traditional Chinese Medicine
关键词
处方点评
Pareto定律
不合理处方
药学服务
prescription review
Pareto's law
irrational prescriptions
pharmaceutical services
