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上海市51家医院处方点评工作现况调查分析
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| 篇名： | 上海市51家医院处方点评工作现况调查分析 |
| TITLE： | |
| 摘要： | 目的：为处方点评工作的持续改进提供科学依据。方法：设计网络调查问卷，以上海市医院药师为对象就医院处方点评工作开展的相关情况进行调查，并对数据进行统计和分析。结果：共回收问卷51份，均为有效问卷，问卷回收有效率为100％；共涉及51家医院。51家医院都采用了二级复核的处方点评模式，二级医院多采用“临床药师初评，专家组复评”模式，占23.53％，而三级医院和综合性医院多采用“门诊药房药师初评，临床药师复评”模式，分别占23.53％和21.57％；三级医院多采用“随机抽取某一阶段全部处方”的抽样方法（占23.53％）；处方点评未使用信息化系统的占45.10％；处方点评频率为每月一次的占86.27％；门诊处方限量规定“不超过2周量”和“不超过1个月量”的占比较高（41.18％和45.10％）；出现不合理使用的常见药物中比例最高的是抗菌药物（占43.14％），超常处方中最常见的问题是“无适应证用药”（占64.71％）；不同类型医院的受访药师对同一问题处方的点评结果存在差异；处方点评工作对医院合理用药和药师能力的促进作用得到普遍认同，但对医师处方行为的影响并不令人满意（仅5.88％认为影响很大）；“提高药师点评能力”、“增加医院领导重视程度”和“增加信息化管理力度”是受访药师对提高处方点评作用最主要的观点和建议。结论：在医院处方点评工作开展过程中，仍应注意提高处方点评权威性和抽样方法科学性，并优化处方点评频率和提升处方点评结果的一致性，还应注意与行政干预更好地结合。 |
| ABSTRACT： | OBJECTIVE： To provide scientific reference for prescription comment. METHODS： Network questionnaire was designed to investigate the development of hospital prescription comment taking hospital pharmacists from Shanghai as the object. The surveyed data were analyzed statistically. RESULTS： A total of 51 effective questionnaires were collected with effective recovery rate of 100％， involving 51 hospitals. Second-level prescription comment mode was adopted in 51 hospitals； the mode of “initial clinical pharmacist comment， expert group re-comment” was mostly adopted in second-level hospitals， accounting for 23.53％. The mode of “outpatient pharmacist initial comment， clinical pharmacist re-comment” was mostly adopted in third-level hospitals and general hospitals， accounting for 23.53％ and 21.57％， respectively. The method of “all prescriptions randomly selected at one stage” was mostly adopted in third-level hospital （accounting 23.53％）. 45.10％ of them did not adopt information system for prescription comment. 86.27％ of surveyed hospitals carried out the review once a month. The limitation on the amount of drugs which were “less than 2 weeks” and “less than 1 month” took up the high proportion （41.18％， 45.10％）. Among irrational used common drugs， antibiotics accounted for the highest proportion （43.14％）. In supernormal prescriptions， the most common problem was drug use without indication （accounting for 64.71％）. Surveyed pharmacists from different types of hospital had different comments on same prescription. The effects of prescription comment on hospital rational drug use and pharmacist’s ability had been widely recognized， but its effects on physician prescribing behavior was not satisfactory （only 5.88％ respondents believed the great effects of prescription comment）. Main ideas and suggestions of surveyed pharmacists for improving the role of prescription comment were “to improve the comment ability of pharmacists”， “to pay more attention by hospital leaders” and “to increase the degree of information management”. CONCLUSIONS： During the process of prescription comment， it is necessary to improve the authority of prescription comment and the scientific sampling method， optimize the frequency of prescription comment and the consistency of comment results， and also pay attention to combination with administrative intervention. |
| 期刊： | 2017年第28卷第33期 |
| 作者： | 段露清，张晴晴，余芸，黄瑾 |
| AUTHORS： | DUAN Luqing，ZHANG Qingqing，YU Yun，HUANG Jin |
| 关键字： | 上海市；医院；处方点评；药师；调查分析 |
| KEYWORDS： | Shanghai；Hospital；Prescription comment；Ph- armacist； Investigation and analysis |
| 阅读数： | 357 次 |
| 本月下载数： | 9 次 |
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