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目的探讨首席药师制度在静脉药物配置中心(PIVAS)合理用药管理中的作用。方法选取2013年1月至2014年1月未实施首席药师制度的PIVAS审核的156 280份医嘱作为对照组;选取2014年3月至2015年3月实施首席药师制度的PIVAS审核的158 923份医嘱作为观察组。比较观察组与对照组干预前后不合理医嘱发生情况,分析观察组医嘱不合理用药情况及干预后医嘱修改情况。结果干预后,观察组不合理医嘱发生率明显少于对照组,差异有统计学意义(P<0.05);观察组医嘱主要不合理用药类型为溶媒不合理,其次为浓度不合理;观察组687例不合理医嘱中,经联系护理人员修改3份,经联系医师修改619份。结论首席药师制度应用于PIVAS合理用药管理中,可以明显降低用药不合理医嘱发生率,有助于提高其合理用药管理水平,促进临床合理用药,确保患者用药安全。
Objective To explore the role of chief pharmacist in the rational administration of drugs in intravenous drug delivery centers (PIVAS). Methods A total of 156 280 medical orders from the PIVAS auditing system that did not implement the chief pharmacist system from January 2013 to January 2014 were selected as the control group and 158 923 medical orders from March 2014 to March 2015 for the PIVAS review of the implementation of the chief pharmacist system As observation group. The observation group and the control group were compared before and after the intervention of unreasonable doctor’s advice, analyze the observation group’s doctor’s advice unreasonable medication situation and the intervention’s doctor’s order modification situation. Results After the intervention, the incidence of unreasonable doctor’s orders in the observation group was significantly less than that of the control group (P <0.05), and the type of unreasonable medication in the observation group was unreasonable, followed by the unreasonable concentration. In observation group 687 Cases of unreasonable doctor’s advice, by the nurses to contact the revised 3, revised by the contact physician 619 copies. Conclusion The application of chief pharmacist system in the rational administration of PIVAS can obviously reduce the incidence of unreasonable medical orders, improve the rational administration of drugs, promote the rational use of drugs and ensure the safety of patients.