目的:了解北京安贞医院(以下简称"我院")静脉用药集中调配中心干预的不适宜处方情况,促进临床合理用药.方法:回顾性分析我院2016年静脉输液处方859 136张,对溶剂不适宜、医嘱录入不适宜、药物浓度不适宜、配伍不适宜等不适宜处方的干预效果进行探讨.结果:859 136张处方中,不适宜处方998张(占0.12%).其中,溶剂不适宜处方(422张,占42.28%)、药物浓度不适宜(316张,占31.66%)、医嘱录入不适宜(159张,占15.93%)和配伍不适宜处方(101例,占10.12%).溶剂不适宜处方中,使用率排序居前3位的药品为舒血宁注射液、疏血通注射液和注射用左卡尼汀;药物浓度不适宜处方中,使用率排序居前3位的药品为氯化钾注射液、盐酸克林霉素注射液和注射用万古霉素;医嘱录入不适宜处方主要为临床医师操作失误或其他意外情况所致;联合用药不适宜处方中,使用率排序居前3位的联合用药为维生素C注射液+胰岛素、注射用甲波尼龙琥珀酸钠+胰岛素、多烯磷脂酰胆碱注射液+氯化钾注射液.经过干预,全部不适宜处方均得到及时纠正.结论:我院静脉用药处方存在一定问题,临床药师通过对不适宜处方进行干预,及时纠正了不合理用药,提高了临床合理用药水平.%OBJECTIVE:To investigate the relevant status of improper intravenous drug prescriptions intervened by Pharmacy Intravenous Admixture Service(PIVAS) in Beijing Anzhen Hospital Affiliated to Capital Medical University(hereinafter referred to as "this hospital"), so as to promote the rational drug use in clinic. METHODS:859 136 prescriptions for intravenous fluids in our hospital from 2016 were retrospectively analyzed in terms of improper compatibility, solvent, drug concentration and prescriptions entry, etc, and the intervention effects were observed. RESULTS:Of the 859 136 prescriptions, 998 cases (0.12%) were improper prescriptions, including improper solvent (422 prescriptions, 42.28%), drug concentration (316 prescriptions, 31.66%), prescriptions entry (159 prescriptions, 15.93%) and compatibility (101 prescriptions, 10.12%). As for improper solvent prescriptions, drugs dominated the top three places were respectively Shuxuening injections, Shuxuetong injections and Levocarnitine for injections. From improper drug concentration prescriptions, the top three drugs were Potassium chloride injections, Clindamycin hydrochloride injections and vancocin vial. The improper prescriptions entry were mainly caused by operational error of clinicians and other contingencies. In terms of improper combination prescriptions, the top three drug combinations were respectively vitamin C + insulin, bornein longsuccinate + insulin injections and Polyene phosphatidyl choline injection+ Potassium chloride injections. After intervention, all improper prescriptions have been corrected. CONCLUSIONS:There are some problems in intravenous drug prescriptions in our hospital, the clinical pharmacists provide interventions on intravenous drug prescription, which can promptly correct errors and improve level of clinical rational drug use.
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