摘要
目的:探讨并分析临床药师对全营养混合液(TNA)处方进行点评和干预对降低此类处方不合格率的效果。方法:将2017年12月至2019年2月期间某医院收集的5399张TNA处方作为研究对象。在2018年6月至8月期间,该医院的临床药师对TNA处方进行点评和干预。将2017年12月至2018年5月期间该医院收集的2222张TNA处方设为对照组,将2018年9月至2019年2月期间该医院收集的3177张TNA处方设为观察组。比较两组TNA处方的不合格率。结果:2018年6月至8月期间,该医院的临床药师共点评1154张TNA处方,共干预461张TNA处方,其中干预成功的处方有237张,占51.4%。在观察组TNA处方中,因TNA中的添加物不稳定、离子浓度超标、糖脂比不当、热氮比不当、组分超量、组分重复、氨基酸使用不当、输注途径不当及处方中未标明在输注TNA时应监测患者的血糖导致不合格的TNA处方所占的比例均低于对照组处方中因上述因素导致不合格的TNA处方所占的比例,差异有统计学意义,P<0.05。在两组TNA处方中,因无适应证使用TNA及TNA中的热量配比不当导致不合格的TNA处方所占的比例相比,差异无统计学意义,P>0.05。结论:临床药师对TNA处方进行点评和干预可降低此类处方的不合格率。
Objective:To investigate and analyze the effect of clinical pharmacists’comments and intervention on the prescription of total nutritional mixture(TNA)on reducing the nonconforming rate of such prescription.Methods:5,399 TNA prescriptions were collected from a hospital between December 2017 and February 2019.Between June and August 2018,clinical pharmacists at the hospital reviewed and intervened on TNA prescriptions.The 2,222 TNA prescriptions collected by the hospital between December 2017 and May 2018 were set as the control group,and the 3,177 TNA prescriptions collected by the hospital between September 2018 and February 2019 were set as the observation group.The rejection rate of TNA prescription was compared between the two groups.Results:From June to August 2018,clinical pharmacists in the hospital reviewed a total of 1,154 TNA prescriptions and intervened 461 TNA prescriptions,among which 237 prescriptions were successful,accounting for 51.4%.TNA prescription in the group,due to the additives of TNA is not stable,ion concentration exceeds bid,sugar,fat than inappropriate,improper hot nitrogen ratio,excess of components,components of repetition,amino acids in the improper use,improper infusion route and prescriptions not indicated in patients with infusion TNA should monitor blood glucose causing unqualified TNA prescription proportion are lower than the control group in the prescription by the above factors lead to the unqualified TNA prescription proportion,the difference was statistically significant,P<0.05).Among the TNA prescriptions of the two groups,there was no statistically significant difference in the proportion of unqualified TNA prescriptions due to the use of TNA without indication and improper heat ratio in TNA,P>0.05.Conclusion:Clinical pharmacists’comments and intervention on TNA prescription can reduce the nonconforming rate of such prescription.
作者
金伟
Jin Wei(Department of Pharmacy,Jincheng University Hospital,Jincheng,Shanxi 048006)
关键词
临床药师
全营养混合液
处方
点评
干预
处方不合格率
Clinical pharmacist
Total nutrient mixture
Prescription
Review
Intervention
Prescription failure rate
