中国药房2024，Vol.35Issue(14)：1690-1695,6.DOI:10.6039/j.issn.1001-0408.2024.14.03
基于循证证据的麻醉科处方前置审核规则精细化设置及效果评价
Practice and effect evaluation of refined setting of evidence-based reference prescription pre-audit rules in anesthesiology department
摘要
Abstract
OBJECTIVE To optimize the pre-audit rules for anesthesia prescriptions,improve the audit quality and rational drug use.METHODS The inpatient medical orders of anesthesia department from prescription pre-audit system of the Affiliated Hospital of Qingdao University(hereinafter referred to as"our hospital")were analyzed from April 1 to 30,2023.The classification statistics and evidence-based inquiry were carried out for irrational drug use issues;combined with our hospital's current implementation of the Anesthesiology Clinical Pathway Medication Standards,the audit rules were set in details,and audit management and communication feedback processes were established.The total number of monthly audited orders,the number of pre-audit pop ups,system interception rate,physician modification rate after system audit,pharmacist audit rate,and reasonable rate of medical orders after refined setting of rules(May-December in 2023)were compared with before setting(April in 2023);the average medication cost per anesthesia session after refined setting of rules was also compared with before setting(May-December in 2022).RESULTS Irrational drug use in the anesthesia department mainly included inappropriate indications,inappropriate administration routes,inappropriate usage and dosage,inappropriate compatibility,medication problems in special populations,and improper medication during the perioperative period.After the refinement of the rules,the number of pre-audit pop ups in the anesthesia department significantly decreased over time,and gradually reached a stable state after continuous improvement.Compared with before setting,the system interception rate after the refinement of rules(P＜0.001),physician modification rate after system audit(P＜0.001)both increased significantly,while the pharmacist audit rate significantly decreased(P＜0.001).There was a linear trend between the reasonable rate of medical orders and the month from May to December in 2023(P＜0.05).Compared with before the setting,the average medication cost of anesthesia per session decreased from 720.72 yuan to 528.21 yuan,with a decrease of 26.71%.CONCLUSIONS Based on evidence-based reference,refining pre-audit rules for anesthesia prescriptions can significantly improve the quality of prescription examination,promote rational drug use,and save patient's medical expenses.关键词
处方前置审核/麻醉科/循证证据/审核规则/合理用药Key words
prescription pre-audit/anesthesia department/evidence-based reference/audit rules/rational drug use分类
医药卫生引用本文复制引用
邢晓敏,李祥鹏,王心怡,魏丽娜,李文静,李静..基于循证证据的麻醉科处方前置审核规则精细化设置及效果评价[J].中国药房,2024,35(14):1690-1695,6.基金项目
国家卫生健康委医院管理研究所医院药学高质量发展研究项目(No.NIHAYS2308) （No.NIHAYS2308）
