我院2021年静脉配置中心不合理医嘱统计与分析
Statistics and Analysis of Unreasonable Medical Orders of Venous Configuration Center in Our Hospital in 2021

目的：了解我院不合理医嘱用药情况，规范临床合理用药，为临床用药提供参考依据，以确保临床医师合理用药及患者静脉用药安全有效。方法：通过中山大学孙逸仙纪念医院(以下简称“我院”)静脉配置中心使用的软件系统，提取2021年1月~2021年12月审核的所有输液医嘱，进行回顾性调查分析。结果：在213,944份输液医嘱中，不合理医嘱339份，在不合理医嘱类型中，给药浓度不当132份(占38.94%)，溶媒选择不当118份(占34.81%)，其他还包括溶媒用量不当、TPN不合理(钾离子、糖胰比)、配伍禁忌等；在不合理医嘱科室分布中，普外科占了40.71%，其次为心胸外科(占23.89%)和儿科血液(11.80%)等；在不合理用药类型中，抗肿瘤药和抗感染药占了多数。结论：我院PIVAS能够有效阻止不合理医嘱的发生，保障医嘱合理性和保证病人用药安全。
Objective: To understand the situation of irrational drug use ordered by doctors in our hospital, standardize rational drug use in clinic, and provide a reference for clinical drug use, so as to ensure rational drug use by clinicians and safe and effective intravenous drug use in patients. Methods: Through the software system used by the Venous Configuration Center of Sun Yat-sen Memorial Hospital of Sun Yat-sen University (hereinafter referred to as “our Hospital”), all transfusion orders reviewed from January 2021 to December 2021 were extracted and analyzed retrospectively. Results: Among 213,944 transfusion orders, 339 were unreasonable medical orders, among the types of unreasonable medical orders, 132 were improper drug concentration (accounting for 38.94%), 118 were improper solvent selection (accounting for 34.81%), and other types included improper solvent dosage, unreasonable TPN (potassium ion, sugar-trypsin ratio), incompatibility, etc. Among the departments with unreasonable medical orders, general surgery accounted for 40.71%, fol-lowed by cardiothoracic surgery (23.89%) and pediatric blood (11.80%). Anti-tumor drugs and anti-infective drugs accounted for the majority of irrational drug use types. Conclusion: PIVAS in our hospital can effectively prevent the occurrence of unreasonable medical orders, ensure the rationality of medical orders and ensure the drug safety of patients.