ABSTRACT
OBJECTIVE: To strengthen pharmacist intervention in prescribing behavior of doctors, so as to further standardize prescribing behavior.METHODS: Through the review of the advantages and disadvantages of the relevant laws, education training and assessment system for prescription intervention in the USA, a deep analysis was made in combination with the Chinese system and the characteristics of the medical staff.RESULTS: A new clinical pathway was introduced to standardize the intervention of doctors′ prescriptions, so as to improve the level of diagnosis and treatment and the environment for medical treatment in China.CONCLUSION: Improving pharmacists′ professional accomplishment and introducing Internet model and intelligent medical technology can improve the linkage among clinical, community medical institutions and social pharmacies, and also enhance the feasibility and reliability of Internet prescription drug purchase intervention. Promote the closed-loop connection and continuous upgrading of the pharmaceutical industry chain, gradually realize the standardization model of diagnosis and treatment, and then promote the results of the overall medical level.
ABSTRACT
OBJECTIVE:To evaluate the application effects of PDCA cycle management in the outpatient prescription intervention.METHODS:A total of outpatient prescriptions (pre-intervention group) during Jan.-Dec.2014 and 918 659 (intervention group) were selected during Jan.-Dec.2015 were selected from a hospital.Irrational 9utpatient prescriptions were analyzed before and after the application of PDCA cycle management,and the improvement of main indexes were compared such as unsuitable usage and dosage,incomplete clinical diagnosis writing,no physicians' signature on the prescription or inconsistent with sample.RE SULTS:Before intervention,there were 2 347 irrational prescriptions,including 1 401 nonstandard prescriptions,849 unsuitable prescriptions and 97 abnormal prescriptions.After intervention,there were 1 161 irrational prescriptions,including 695 nonstandard prescriptions,425 unsuitable prescription and 41 abnormal prescriptions,decreasing 50.53％,50.39％ 49.94％ and 57.73％,respectively.The proportion of unsuitable usage and dosage,incomplete clinical diagnosis writing,no physicians' signature on the prescription or inconsistent with sample,nonstandard prescription paper,unsuitable indications,no signature and date for prescription revision or no reason and new signature for overdose use,outpatient prescriptions more than 7 d common dose or emergency prescriptions more than 3 d common dose without special situation in total amount of outpatient prescriptions decreased from 0.72‰,0.57‰,0.45‰,0.27‰,0.20‰,0.19‰ and 0.15‰ before intervention to 0.32‰,0.25‰,0.19‰,0.11‰,0.09‰,0.08‰ and 0.07‰ after intervention.CONCLUSIONS:PDCA cycle management significantly improves the quality of outpatient prescriptions.There still are irrational outpatient prescriptions in this hospital,and it is to be intervened continuously.
ABSTRACT
OBJECTIVE:To improve the level of rational drug use,and to reduce the workload of clinical pharmacists. METH-ODS:Established“Intelligent Management and Solution for Clinical Rational Drug Use”of our hospital was introduced,including post-prescription review(all prescriptions review)system, self-maintenance system for rational drug use knowledge base,pre-pre-scription review (rational drug use real-time review) early warning system. The effects of intelligent system were evaluated. RE-SULTS & CONCLUSIONS:After the application of the system,the following aspects could be achieved,including“all prescrip-tions review”,“multi-prescriptions/longitudinal review”,system knowledge base real-time update and autonomous definition of re-view rules,effective communication and intervention between physicians and pharmacists before printing prescription by Yaozhidao instant messaging system. Through related trial evaluation,the proportion of false positive prescriptions decreased by 17.65% after 4 months of the application of the system;drug consultation prescriptions review average score of outpatient pharmacists increased from 81 to 94.85;the time of prescription review decreased by 4.72-5.46 times. Through mandatory interception of unqualified pre-scriptions,severe warning,timely prompt and pharmacists’intervention,the rate of unqualified prescriptions pre-reviewed by the system in respiration department decreased from 32% in Jan. 2015 and 21% in May to 4.62% in Dec. So,the application of the system promotes rational drug use in outpatient department,reduces the workload of pharmacists and ensures the safety of drug use comprehensively.