中国临床药学杂志

目的 通过开展医嘱审核，促进合理用药，保证临床用药安全。方法 对医院2020年1-12月份所有住院患者实施医嘱审核与干预，分析2020年4个季度用药医嘱合理性情况与干预效果，以及对相关药学指标的影响与变化，逐步提高临床用药的合理性。结果 第4季度不合理医嘱率与第1季度相比较显著下降（P <0.05），第3、4季度干预成功率与第1季度相比较得到了显著提升（P <0.05）。不合理医嘱主要表现在重复给药、联合用药不适宜、用药疗程不适宜三大类别。药品收入占医疗收入总费用比例、辅助药品费用占药费、抗菌药物使用率、联合使用抗菌药物比例、静脉输液患者平均用药疗程均显著下降，与第1季度相比较，差异具有统计学意义（P <0.05）。结论 通过执行严格的医嘱审核与干预措施，可提高临床合理用药水平，保证临床用药的安全性与有效性。

AIM To promote the rational drug use and ensure the safety of clinical drug use by carrying out the review of medical advice. METHODS All inpatients from January to December 2020 were audited and intervened by medical orders. The rationality of medical orders and intervention effects, as well as the influences and changes on relevant pharmaceutical indicators in the four quarters of 2020 were analyzed, and the rationality of clinical drug use was improved.RESULTS The rate of unreasonable medical orders in the fourth quarter was significantly lower than that in the first quarter(P < 0.05), and the success rate of intervention in the third and fourth quarters was significantly higher than that in the first quarter(P < 0.05). Unreasonable doctor's advice mainly included three aspects: repeated administration,inappropriate combined medication and inappropriate treatment course. Proportion of drug income to total medical income, proportion of auxiliary drug cost in drug cost, utilization rate of antibacterial drugs, proportion of combined use of antibacterial drugs, and the average duration of intravenous infusion all decreased significantly, with statistically significant differences compared with the first quarter(P < 0.05). CONCLUSION Through the implementation of strict medical advice review and intervention measures, the level of rational clinical drug use can be improved to ensure the safety and effectiveness of clinical drug use.