某院 1 467 张门急诊抗菌药物处方不合理用药因素的帕累托分析

赵华, 郭胜蓝, 危丽琴, 王浩奎, 方健, 罗崇彬

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抗感染药学 ›› 2020, Vol. 17 ›› Issue (6) : 805-808. DOI: 10.13493/j.issn.1672-7878.2020.06-008
合理用药

某院 1 467 张门急诊抗菌药物处方不合理用药因素的帕累托分析

  • 赵华*1, 郭胜蓝, 危丽琴, 王浩奎, 方健, 罗崇彬*2
作者信息 +

Pareto Analysis of Unreasonable Medication of 1 467 Prescriptions of Antibiotics in Outpatient and Emergency in a Hospital

  • ZHAO Hua*1, GUO Sheng-lan, WEI Li-qin, WANG Hao-kui, FANG Jian, LUO Chong-bin*2
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摘要

目的: 分析医院门急诊抗菌药物不合理使用的原因与特点,促进合理用药。方法: 抽取 2016 年—2018年3 年间诊疗的 TOP 50 医生开具的抗菌药物处方(10 张/人,每月 500 张,计 18 000 张),点评其用药的合理性,并将不合理用药处方按照不合理用药类型采用帕累托图找出其原因与对策。结果: 18 000张门急诊抗菌药物处方中,1 467 张处方存在不合理用药因素,其中遴选的药品、剂型、给药途径和用法用量不适宜(1 046 张占 71.30%),次要因素为序贯选药不适宜(94 例占 6.41%)、无特殊情况下未优先选用基本药物(76 例占 5.18%)及治疗用抗菌药物合理疗程大于 3 d(含 3 天以上)(69 例占 4.70%)。结论: 采用帕累托图分析导致不合理用药的主要因素,有效干预并制定改进方案,从而提高了门急诊抗菌药物临床用药的合理性。

Abstract

Objective: To analyze the reasons and characteristics of unreasonable use of antibiotics in outpatient and emergency department, and to promote the rational use of antibiotics. Methods: The TOP 50 prescriptions of antibiotics issued by doctors in the three years from 2016 to 2018 (10 prescriptions per person, 500 prescriptions per month, a total of 18,000) were selected to comment on the rationality of their use, and the reasons and countermeasures of unreasonable prescriptions were found by using Pareto Chart according to the types of irrational medication. Results: 18 000 copies of this antimicrobial prescription, 1 467 drug prescription had unreasonable factors, including the selection of drugs, dosage form, drug delivery and usage; dosage was not suitable for 71.30% (1 046), the secondary factor for sequential medicine choice was not suitable for 94 cases (6.41%), not in the absence of any special priority selection of essential medicines 76 cases (5.18%) and therapeutic use of antimicrobial agents was greater than the reasonable treatment 3 d (contain more than 3 days) 69 cases (4.70%). Conclusion: The main factors that led to unreasonable drug use were analyzed by Pareto Chart, intervention and improvement plan was effectively made, so as to improve the rationality of clinical antibiotics medication of outpatient and emergency.

关键词

处方点评 / 不合理处方 / 抗菌药物 / 帕累托图 / 合理用药

Key words

prescription comment / unreasonable medication / antibacterial drugs / Pareto chart / rational drug use

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导出引用
赵华, 郭胜蓝, 危丽琴, 王浩奎, 方健, 罗崇彬. 某院 1 467 张门急诊抗菌药物处方不合理用药因素的帕累托分析. 抗感染药学. 2020, 17(6): 805-808 https://doi.org/10.13493/j.issn.1672-7878.2020.06-008
ZHAO Hua, GUO Sheng-lan, WEI Li-qin, WANG Hao-kui, FANG Jian, LUO Chong-bin. Pareto Analysis of Unreasonable Medication of 1 467 Prescriptions of Antibiotics in Outpatient and Emergency in a Hospital. KANGGANRAN YAOXUE. 2020, 17(6): 805-808 https://doi.org/10.13493/j.issn.1672-7878.2020.06-008

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