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·药师与药学服务·


        我院高警示药品管理及风险控制                                     Δ


               *
        江贺春 ,倪伟健,伍章保(中国科学技术大学附属第一医院/安徽省立医院药剂科,合肥 230001)
                              #
        中图分类号 R954          文献标志码 A           文章编号 1001-0408(2021)09-1108-06
        DOI 10.6039/j.issn.1001-0408.2021.09.14

        摘   要   目的:探索我院高警示药品管理模式,为医疗机构对该类药品的管理和使用提供参考。方法:按照中国药学会医院药学
        专业委员会《高警示药品推荐目录》(2019版)制订我院高警示药品目录及风险点,对全院医师、药师、护士进行相关培训与考核;
        以临床科室、药学部门的高警示药品管理和使用合格率为检查指标,比较优化前后高警示药品管理和使用的效果。结果:我院通
        过建立检查督导小组、药师宣教、信息化管理、处方审核及个体化给药、用药指导、处方点评及用药错误上报等措施对高警示药品
        进行风险控制和持续优化。与优化前比较,优化后临床科室高警示药品管理和使用合理率由37.3%提高至80.1%(P<0.01),药学
        部门高警示药品管理和使用合理率由59.2%提高至85.0%(P<0.01);但仍存在高警示药品账物不符、用药错误未全部及时上报、
        审方软件规则建立不完善、用药指导不充分、个体化给药药品品种较少等问题。结论:通过对高警示药品管理及优化,有效提高了
        我院临床科室及药学部门对该类药品的管理和使用水平。
        关键词 高警示药品;风险点;检查指标;风险控制

        High-alert Drug Management and Risk Control in Our Hospital
        JIANG Hechun,NI Weijian,WU Zhangbao(Dept. of Pharmacy,the First Affiliated Hospital of USTC/Anhui
        Provincial Hospital,Hefei 230001,China)

        ABSTRACT    OBJECTIVE:To explore high-alert drug management mode of our hospital,and to provide reference for the
        management and utilization of this category in medical institutions. METHODS:According to High-alert Drug Catalog (2019
        edition)issued by Hospital Pharmacy Committee of Chinese Pharmaceutical Association,the high-alert drug catalog of our hospital
        and their risk points were formulated. Relevant training and assessment were conducted for physicians,pharmacists and nurses
        throughout the hospital. Using qualification rate of high-alert drug management and utilization as index,the effectiveness of
        high-alert drug management and utilization were compared before and after optimization. RESULTS:In our hospital,the risk of
        high-alert drugs was controlled by establishing inspection and supervision group,pharmacist education,information management,
        prescription review and individualized administration,medication guidance,prescription review and medication error reporting and
        other measures and with continuous optimization. Compared with before optimization, qulification rate of high-alert drug
        management and utilization increased from 37.3% to 80.1% in clinical departments(P<0.01),and that increased from 59.2% to
        85.0% in pharmacy department(P<0.01). There were still some problems,such as the inconsistency of high-alert drugs accounts
        and materials,the failure to report all medication errors in time,the imperfect establishment of prescription review software rules,
        the insufficient medication guidance, and the lack of individual medication varieties. CONCLUSIONS: By optimizing the
        management of high-alert drugs,the management and utlization of this category is improved effectively in clinical departments and
        pharmacy departments of our hospital.
        KEYWORDS     High-alert drugs;Risk points;Inspection indicators;Risk control



            高警示药品在我国曾被称为高危药品、高危药物或                          协 会(Institute for Safe Medication Practices,ISMP)提
        高警讯药物。高警示药品的概念最早由美国安全用药                             出。1995-1996 年,美国 ISMP 开展了关于何种药品在
            Δ 基金项目:国家自然科学基金青年科学基金资助项目(No.8180-              何种情况下会对患者健康造成伤害的研究,共有 161 个
        3602);安徽省教育厅高等学校省级质量工程项目(No.2020jyxm2307)           医疗机构参与。研究结果显示,大多数导致患者死亡或
            *主管药师,硕士研究生。研究方向:药理学、药事管理学。电
                                                            严重伤害的事件是由特定的少数药物引起的。美国
        话:0551-62283613。E-mail:316267876@qq.com
                                                            ISMP 由此提出高警示药品的概念,将一些当使用不当
            # 通信作者:副主任药师。研究方向:药事管理学、临床药学。电
        话:0551-62283613。E-mail:1151005763@qq.com            时会对患者造成严重伤害或导致死亡的药物称为“高警


        ·1108 ·  China Pharmacy 2021 Vol. 32 No. 9                                   中国药房    2021年第32卷第9期
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