某院住院患者参麦注射液使用的基线调查分析及干预策略.pdfVIP

某院住院患者参麦注射液使用的基线调查分析及干预策略 ＊ 陆奇志 ，曾 嵘，赵应学，蔡均玲（广西江滨医院药剂科，南宁 530021） 中图分类号 R95 文献标志码 C 文章编号 1001-0408（2013）12-1125-02 DOI 10.6039/j.issn. 1001-0408.2013.12.25 摘 要 目的：了解某“三甲”医院参麦注射液临床应用情况，探索中药注射剂医嘱点评的指标和实施方法，为制定干预策略提供 参考。方法：抽查某“三甲”医院2011年5－12月所有使用参麦注射液的病历共208份，参照药品说明书和有关法律法规、指导原 则，对其用药情况进行调查、分析。结果：病历中不合理用药现象主要涉及不按“医保”限定支付范围用药、溶媒选择不当、给药疗 程不当、不稀释直接静脉滴注、辨证用药不适宜、给药剂量不合理、配伍不合理等方面。结论：某“三甲”医院参麦注射液应用存在 诸多不规范问题，医院管理者应制定合理的监测管理制度，并督导临床医师、药师共同关注以提高中药注射剂的合理应用水平。 关键词 医嘱点评；参麦注射液；不合理用药；基线调查；干预策略；临床药师 Analysis and Intervention Strategy of Baseline Investigation for Shenmai Injection in the Inpatients of a Hospital LU Qi-zhi ，ZENG Rong ，ZHAO Ying-xue ，CAI Jun-ling（Dept. of Pharmacy ，Guangxi Jiangbin Hospital ，Nan- ning 530021，China ） ABSTRACT OBJECTIVE ：To understand the clinical application of Shenmai injection in a “third-grade class-A”hospital and ex- plore the indicators and implementation methods of doctor ’s advice evaluation for TCM injections ，and to provide reference for the development of intervention strategies. METHODS ：During May －Dec. in 2011，208 medical records of Shenmai injection were collected from a third-grade class-A hospital. Referring to the package insert and the relevant laws and regulations ，guidelines ，med- ication of medical records were investigated and analyzed. RESULTS ：The phenomenon of irrational use of drugs in the medical re- cords involved exceeding the qualified payment range of Medical Insurance ，the inappropriate choice of solvent ，improper course of treatment ，direct infusion without dilution ，unsuitable medication by syndrome differentiation ，unfit drug dosage and unreason- able compatibility ，etc. CONCLUSION ：The applications of Shenmai injection in a “third-grade class-A”hospital have normative issues ；department managers should formulate reasonable detection and management system ，and keep common concern of clin