药师主导的肠外营养处方审核策略的分析与改进

doi:10.5246/jcps.2022.02.012

中国药学(英文版) ›› 2022, Vol. 31 ›› Issue (2): 142-152.DOI: 10.5246/jcps.2022.02.012

• 【药事管理与临床药学专栏】 • 上一篇下一篇

药师主导的肠外营养处方审核策略的分析与改进

涂颖秋^#, 胥甜甜^#, 彭洪薇, 陈长仁, 赖鑫, 万青, 潘德城^*(), 张洁^*()

南昌大学第一附属医院, 江西南昌 330006

收稿日期:2021-10-09 修回日期:2021-12-05 接受日期:2021-12-14 出版日期:2022-02-27 发布日期:2022-02-25
通讯作者: 潘德城, 张洁
作者简介:
+ Tel.: +86-15879042067, E-mail: pandecheng1987@126.com
+ Tel.: +86-13970800566, E-mail: 798783079@qq.com
基金资助:
Science and Technology Project of Jiangxi Health Commission (Grant No. 20185191).

The analysis and improvements of pharmacist-led parenteral nutrition prescription review strategies

Yingqiu Tu^#, Tiantian Xu^#, Hongwei Peng, Zhangren Chen, Xin Lai, Qing Wan, Decheng Pan^*(), Jie Zhang^*()

The First Affiliated Hospital of Nanchang University, Nanchang 330004, Jiangxi, China

Received:2021-10-09 Revised:2021-12-05 Accepted:2021-12-14 Online:2022-02-27 Published:2022-02-25
Contact: Decheng Pan, Jie Zhang
About author:
# Yingqiu Tu and Tiantian Xu contributed equally to this work.

摘要/Abstract

摘要：

不断完善肠外营养处方审核策略, 提高药师处方审核的效率和准确率。药师设计计算公式和电子处方审核系统, 对审核策略不断进行改进, 改进分为三个阶段: 改进前、改进第一阶段和改进第二阶段。对2019年1月至5月、2019年6月至10月和2020年6月至10月接受肠外营养支持的住院患者进行回顾性分析, 以评估肠外营养处方审查的准确率和审核效率。与改进前相比, 改进第一阶段肠外营养处方审核效率提高。此外, 在改进第二阶段, 肠外营养处方审核的效率和准确率显著提高(P < 0.01)。通过对肠外营养处方审核策略的改进, 提高了肠外营养处方审核的效率和准确性。此外, PDCA循环法有助于今后肠外营养审核过程的改进。

关键词: 审方药师, 肠外营养, 审核策略, PDCA循环方法

Abstract:

To improve the efficiency and correctness of the review, we aimed to continuously improve the review strategy of parenteral nutrition (PN) prescriptions. A calculation formula (CF) and an electronic prescription reviewing system (EPRS) were designed to improve efficiency. The improvements were divided into three periods: pre-improvement, improvement period-1 (CF was used), and improvement period-2 (EPRS-CF was used). A retrospective analysis for inpatients receiving PN support from January to May 2019, June to October 2019, and June to October 2020, was conducted to evaluate the defect and efficiency of the PN prescription review. Compared with the pre-improvement period, the efficiency of the PN prescription review in the CF period was improved. In addition, in the EPRS-CF period, the efficiency and correctness of the PN prescription review were remarkably increased (P < 0.01). Moreover, through the verification of PN prescriptions in the EPRS-CF period, pharmacists improved the efficiency and correctness of the PN prescription review. Besides, the PDCA (plan-do-check-act) circulation method could help improve the PN reviewing process in the future.

Key words: Prescription-reviewing pharmacists, Parenteral nutrition, Review strategies, PDCA circulation methods

Supporting:

涂颖秋, 胥甜甜, 彭洪薇, 陈长仁, 赖鑫, 万青, 潘德城, 张洁. 药师主导的肠外营养处方审核策略的分析与改进[J]. 中国药学(英文版), 2022, 31(2): 142-152.

Yingqiu Tu, Tiantian Xu, Hongwei Peng, Zhangren Chen, Xin Lai, Qing Wan, Decheng Pan, Jie Zhang. The analysis and improvements of pharmacist-led parenteral nutrition prescription review strategies[J]. Journal of Chinese Pharmaceutical Sciences, 2022, 31(2): 142-152.

图/表 7

Figure 1. The review strategies of this study involved two staetegies and three stages.

Table 1. (A) Nutrition content per unit for medications; (B) Nutrition contents calculation table; (C) Indexes in parenteral nutrients.

Figure 2. Grade setting diagram of the review rule.

Figure 3. Review rules for PN (includes fat emulsions, sugars, amino acids) set by prescription-reviewing pharmacists in the information system.

Figure 4. A flow chart of the review rules of the pharmacists.

Table 2. Comparison for work efficiencies of PN prescription review.

Figure 5. (A) Proportions for different types of defective PN prescriptions; (B) Different types of defective PN prescriptions under the pre-improvement stage; (C) Different types of defective PN prescriptions inder improvement stage-1 (CF stage); (D) Different types of defective PN prescriptions under improvement stage-2 (ERPS-CF stage).

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药师主导的肠外营养处方审核策略的分析与改进

The analysis and improvements of pharmacist-led parenteral nutrition prescription review strategies

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