| 摘要: |
| 目的:分析我院儿科门急诊不合理处方分布特征及审核模式,量化评估双审核模式在儿科门急诊处方干预中的效能,从 而优化处方审核流程,促进儿科门急诊安全合理用药。 方法:采用回顾性队列分析方法,收集整理 2024 年 9 月-2025 年 5 月儿 科门急诊的不合理处方数据,通过医院信息系统(HIS)与临床合理用药智能管理系统,结合帕累托图分析法,对比双模式审核 (系统前置审核+药师人工复核)与历史同期(2023 年 9 月-2024 年 5 月)纯系统审核数据,统计指标为不合理处方发生率、不合 理类型分布等。 结果:双审核模式拦截不合理处方 104 852 张(发生率 15. 76%),主要类型为用法用量不适宜(54. 05%)、适应 证不适宜(25. 35%);人工审核补充拦截处方 40 张,其中用法用量不适宜与遴选药品不适宜为高风险漏洞。 双模式审核的即时 拦截效能提升了 18. 93%(P<0. 01)。 结论:双模式审核通过人机协同可有效降低不合理用药风险,应持续建立药师全量复核机制, 强化对系统规则难以覆盖的儿科个体化用药问题的干预能力,并动态优化前置审核规则库,促进儿科临床合理规范用药。 |
| 关键词: 前置审核 人工复核 儿科 处方 合理用药 帕累托图 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.06.010 |
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| 基金项目:上海市卫健委科研项目,编号 20234Y0035 |
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| Intervention of System Pre-Review Combined with Pharmacist Re-Review in Reducing Irrational Prescription Rate in Pediatric Outpatient and Emergency Department |
| Ma Yizong, Ding Yifan, Lu Xiaotong, Xu Anni, Liu Chengbo, Tang Huiyi |
| (Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China) |
| Abstract: |
| Objective: To evaluate the efficacy of the dual-review model for intervention in pediatric outpatient and emergency prescriptions by analyzing the distribution characteristics of irrational prescriptions and comparing the review models, so as to optimize the prescription review process and enhance medication safety and rational drug use in Pediatric Outpatient and Emergency Department. Methods: A retrospective cohort study was conducted on irrational prescription data from the Pediatric Outpatient and Emergency Department from Sept. 2024 and May 2025. Using the Hospital Information System (HIS) and the Clinical Rational Drug Use Intelligent Management System, Pareto analysis was employed to compare data under the dual-review model ( system pre-review + pharmacist manual verification) with historical data from the same period ( from Sept. 2023 to May 2024) under a system-only review model. Statistical indicators included the incidence of irrational prescriptions and distribution of irrationality types. Results: The dual-review model intercepted 104,852 irrational prescriptions ( with an incidence of 15. 76%). The most common types of irrationality were inappropriate dosage and usage (54. 05%) and inappropriate indication (25. 35%). Manual verification supplemented the process by intercepting an additional 40 prescriptions, identifying inappropriate dosage and usage and inappropriate drug selection as high-risk categories. The dual-review model significantly increased the instant interception capability rate by 18. 93% (P<0. 01). Conclusion: The dual-review model, through manual verification combined with system pre-review, effectively reduces the risk of irrational medication. It is necessary to continuously establish a pharmacist full verification mechanism and strengthen the intervention capabilities for individualized pediatric medication issues that cannot be fully covered by rules, and dynamically optimize the rule library for system pre-review to further promote rational and standardized medication in pediatric care. |
| Key words: pre-review manual re-review Pediatrics prescriptions rational medication Pareto chart |
