基于合理用药的静脉用药医嘱闭环管理在降低 PIVAS 输液调配量中的成效分析.

OBJECTIVE: To reduce the irrational rate of intravenous medical orders and improve the effectiveness of medical orders monitoring, and reduce the number of pharmacy intravenous admixture services ( PIVAS) infusions. METHODS: Relying on the knowledge base of rational drug use, pharmacists in the hospital combined the intelligent prescription pre-review system with intervention in clinical practice, and full medical orders review and post evaluation to form the closed-loop management mode for intravenous medication. Changes in the number of PIVAS intravenous infusion dispensing bags before implementation of closed-loop management (from Jul. to Dec. 2019) and after implementation of closed-loop management ( from Jul. to Dec. 2020) were compared. Application of proton pump inhibitors ( PPI), consumption amount of antibiotics, application rate of intravenous infusion in inpatients, and number of irrational review on medical orders were compared and analyzed. RESULTS: After implementation of closed-loop management, the average number of daily infusion in PIVAS decreased from (2 903±353) bags to (2 451±247) bags, the difference was statistically significant (P<0. 01); the average number of daily PPI decreased from (463. 03±89. 62) bags to (169. 39± 30. 59) bags, the difference was statistically significant (P<0. 01); the average number of daily antibiotics decreased from (204. 00 ± 31. 75) bags to (129. 71 ± 41. 30) bags, the difference was statistically significant (P < 0. 01); the application rate of intravenous infusion in inpatients increased from 88. 50% (28 406/ 32 097) to 87. 00% (30 748/ 35 342), with the reduction rate of 1. 69%; the number of review on irrational inpatient medical orders decreased from 854 cases to 426 cases, with a decrease of 50. 12%. CONCLUSIONS: The implementation of closed-loop management of intravenous medication orders based on rational drug use can significantly improve the rationality of intravenous medication orders of inpatients and ultimately reduce the rate of intravenous infusion. [ABSTRACT FROM AUTHOR]