Page 26 - 《中国药房》2024年19期

我国医疗机构PIVAS医嘱审核情况调研分析
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赵 婧 ，孙路路 ，吕红梅 ，张建中 （1.复旦大学附属中山医院药剂科，上海 200032；2.国家卫生健康委医院
管理研究所药事管理研究部，北京 100044；3.上海市老年医学中心药剂科，上海 201104）
中图分类号 R952 文献标志码 A 文章编号 1001-0408（2024）19-2340-05
DOI 10.6039/j.issn.1001-0408.2024.19.04

摘 要 目的 了解全国医疗机构静脉用药调配中心（PIVAS）医嘱审核现状，进一步提升PIVAS医嘱管理水平，减少与杜绝静脉
给药错误的发生。方法 通过问卷调研法，针对全国医疗机构PIVAS医嘱审核的问题和现状，由调研组中的各省（自治区、直辖市）
专家负责组织本省份内相关医疗机构的 PIVAS 负责人填写医嘱审核和不适宜医嘱干预情况的问卷，并对结果进行统计分析。
结果 共收到关于PIVAS医嘱审核的有效问卷751份。我国PIVAS医嘱审核主要以人工与计算机相结合的方式进行。PIVAS每
日医嘱审核条数的中位数为 700.00～771.00 条；每日新增医嘱审核条数的中位数为 209.68～215.00 条；平均医嘱审核率为
85.50%～92.44%；不适宜医嘱平均占比为 1.82%～1.89%；不适宜医嘱平均干预率为 74.90%～79.41%，平均干预成功率为
79.62%～87.28%；退药率为2.92%～3.08%。结论 我国大部分医疗机构PIVAS的医嘱审核采用审方软件辅助，个别PIVAS存在医
嘱不审核、不适宜医嘱不干预等情况，医嘱审核的标准及流程有待完善。建议强调药师审方责任制，规范化使用审方软件，逐步扩
大医嘱审核范围，并采用多部门协作方式，从而提高不适宜医嘱的干预成功率、降低PIVAS退药率。
关键词 静脉用药调配中心；医嘱审核；审方软件

Investigation and analysis of the medical prescription approval in PIVAS in China
ZHAO Jing ，SUN Lulu ，LYU Hongmei ，ZHANG Jianzhong（1. Dept. of Pharmacy， Zhongshan Hospital，
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Fudan University， Shanghai 200032， China；2. Dept. of Pharmaceutical Administration Research， National
Institute of Hospital Administration， National Health Commission， Beijing 100044， China；3. Dept. of
Pharmacy， Shanghai Geriatric Medical Center， Shanghai 201104， China）

ABSTRACT OBJECTIVE To know about the current status of medical order auditing in pharmacy intravenous admixture service
（PIVAS） of medical institutions nationwide， further improve the management of medical orders in PIVAS， and reduce and
eliminate the occurrence of intravenous medication administration errors. METHODS Through the questionnaire survey method， to
address the problems and current situation of PIVAS medical order auditing in medical institutions nationwide， experts from each
province （autonomous region， municipality directly under the central government） in the research group were responsible for
organizing the PIVAS directors of relevant medical institutions in their provinces to fill in the questionnaires on medical order audit
and inappropriate medical order interventions， and conduct a statistical analysis of the results. RESULTS A total of valid 751
responses were received to the PIVAS questionnaire on the review of medical prescriptions. Our PIVAS medical order audit is
mainly carried out by a combination of manual and computer. The median number of medical orders were audited by PIVAS per
day were 700.00-771.00； the median number of new medical orders were audited by PIVAS per day were 209.68-215.00； medical
order auditing rates were 85.50%-92.44% averagely； the inappropriate doctor’s orders accounted for 1.82%-1.89% averagely； the
intervention rates of inappropriate medical orders ranged 74.90%-79.41%， the success rates of intervention were 79.62%-87.28%
averagely； the medication refund rates were 2.92%-3.08%. CONCLUSIONS Most of the PIVAS in China’s healthcare institutions
use medical order review software to assist in the review of

Δ 基金项目 国家卫生健康委医院管理研究所横向项目（No. medical orders， and there are cases of individual PIVAS in
202207200959000030162）；中国药师协会项目：静脉用药调配中心工 which medical orders are not reviewed comprehensively and
作调研（No.国药协函〔2022〕34号） inappropriate orders are not intervened in， and the standards
＊ 第一作者 主 管 药 师 。 研 究 方 向 ：静 配 药 学 。 电 话 ：021-
and processes of medical prescription review need to be
64041990。E-mail：zhao.jing1@zs-hospital.sh.cn
# 通信作者 主 任 药 师 。 研 究 方 向 ：静 配 药 学 。 电 话 ：021- improved. It is recommended to emphasize the pharmacist’s
51371990。E-mail：20792358@qq.com responsibility system， standardize the use of prescription

· 2340 · China Pharmacy 2024 Vol. 35 No. 19 中国药房 2024年第35卷第19期