摘要
Abstract
Objective To investigate the exceeded manual medicine situation of pediatric respiratory ward of the First Hospital of Jilin University,and to analyze the influencing factors.Methods A cross-sectional study was used to design scheme of experiment,by using the principle of equidistant sampling from September 2014 to September 2015,500 aged 0 to 18 years patient records of pediatric respiratory ward of the hospital HIS system were selected,the doctor's advice related to the drug was extracted,anddoctor's oral advice,carrying or returning advice,and about 0.9％ sodium chloride injection and other similar orders were excluded.The general information and advice were collected to judge if the orders exceeded the manual by age,drug kinds,types of disease and the doctor's advice,logistic regression analysis was used to analyze the risk factors.Results 500 patient records were included into in this paper,including 465 cases,18 082 orders,16 618 hospital medication orders,1 464 off-hospital carrying medicine orders.196 drugs were involved,mainly were the respiratory medicine and system anti-infection medicine.(1) In 500 patient records the exceeding medicine rate was 100％.There were 4 717 exceeded medicine orders (26.1％),9.4 super medication orders in each patient record,and 1.4 super medicine orders in each record.(2) Different exceeded manual medicine comparison:the incidence of without children's usage and dosage (17.4％) was twice of the incidence of other types.(3) Different ages:the overall incidence of exceeded manual medicine difference was statistically significant,the smaller the age,the higher the incidence (P=0.000).(4) Different drug varieties comparison:the overall incidence of exceed manual medicine use system anti-infection drugs (35.7％),respiratory medicine drugs (32.1％) and cardiovascular system (21.8％) were higher;Antiviral drugs were higher than antibacterial drugs (P=0.000),and focused on no child usage and dosage;Asthma drug was higher than antitussive expectorant (P=0.020),the former mainly focused on no children's usage and dosage,the later mainly focused on no method and no children's usage and dosage;Super taboo could be found in the digestive system drugs and other drugs.(5) Comparing different disease types:overall exceed manual medicine rate from high to low was pneumonia,severe pneumonia,bronchitis,bronchial asthma and other diseases,pharyngitis and bronchial foreign body.(6) Different orders:the overall incidence of super manual medicine hospital doctor's advice was lower than off hospital carrying medicine doctor's advice.(7) Logistic regression analysis:compared with infants,in school-age + adolescence the incidence was reduced by 20％;Compared with the system anti-infection drugs,the respiratory system drugs were reduced by 15％;Compared with pneumonia,the risk of rest of the diseases decreased;Compared with senior titles,in intermediate grade and junior titles the risk reduced by 86％ and 84％.Conclusion In pediatric respiratory ward exceeded manual medicine phenomenon is widespread,and no children usage and dosage are the main drug super manual type,followed by the super method.关键词
超说明书用药/小儿呼吸/用药安全Key words
Ultra specification drug use/Pediatric respiratory/Medication safety
