急诊、儿科药房不合理处方分析及干预措施

冯菁菁 贾琳

摘 要 目的：为急诊、儿科的不合理用药找到预防措施，减少和避免不合理处方的出现，做到合理用药。方法：对等距随机抽取到的2017年急诊、儿科的处方进行点评，并对不合理处方进行分类分析。结果：急诊和儿科不合理处方占各自处方总数的3.01% 和1.89%，两科室不合理处方类型主要有青霉素类及头孢菌素类抗生素皮试结果未标明、剂量错误、给药次数问题、溶媒选择问题、超天数用药、配伍禁忌以及超说明书用药这七个方面。结论：我院急诊、儿科药房处方合理性良好，但仍存在问题，针对问题提出相关措施，加强处方管理和合理用药的监督，促进临床合理用药。

关键词 处方点评 不合理处方 干预措施

中图分类号：R969.3 文献标志码：C 文章编号：1006-1533（2018）19-0054-03

Analysis of irrational prescriptions in the pharmacies of emergency & pediatrics and intervention measures

FENG Jingjing*， JIA Lin

（Department of Pharmacy， the Second Hospital of Tianjin Medical University， Tianjin 300211， China）

ABSTRACT Objective： To find some preventive measures for irrational drug use in emergency & pediatrics department， reduce and avoid the occurrence of irrational prescriptions and finally to reach rational use of drugs. Methods： The emergency& pediatrics prescriptions in 2017 extracted by random equidistant sampling were commented， in which the irrational ones were classified and analyzed. Results： The number of irrational prescriptions in emergency and pediatric departments accounted for 3.01% and 1.89% of the total prescriptions of each department. The types of irrational prescriptions were involved in seven aspects such as no skin test results of penicillins and cephalosporins， dosage error， problems with administration times and solvent selection， ultra-day medication， drug incompatibility and off-label medication. Conclusion： The prescription in the departments of emergency & pediatrics of our hospital is reasonable， however some problems still exist. Some relevant measures are proposed in view of the problems and the supervision of prescription management and rational use of drugs should be strengthened so as to finally promote clinical rational use of drugs.

KEy WORDS prescription comment；irrational prescription； intervention measure

处方点评结果分为合理处方与不合理处方，不合理处方包括不规范处方、用药不适宜处方及超常处方[1]。随着科技的进步，计算机机打处方已在各大医疗机构普遍实施，不规范处方中的处方前记、正文、后记内容缺项；书写不规范或者字迹难以辨认；医师签名、签章不规范或者与签名、签章的留样不一致；未使用药品规范名称开具处方；藥品的剂量、规格、数量、单位等书写不规范或不清楚；用法、用量使用“遵医嘱”、“自用”等字句含糊不清；单张门、急诊处方超过5种药品等情况已经基本消除，但用药不适宜处方和超常处方这类不合理处方仍然存在，需要我们药师以及医师去努力解决。本研究对本院急诊、儿科药房2017年不合理处方进行分析并提出干预措施。……