我院儿童处方医嘱知识库建设与处方前置审核系统的运行实践

吴丹, 徐颖, 张旭晖, 郑锋, 陈灏, 李智平

中国药学杂志 ›› 2020, Vol. 55 ›› Issue (12) : 1046-1050.

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中国药学杂志 ›› 2020, Vol. 55 ›› Issue (12) : 1046-1050. DOI: 10.11669/cpj.2020.12.015
论著

我院儿童处方医嘱知识库建设与处方前置审核系统的运行实践

  • 吴丹, 徐颖, 张旭晖, 郑锋, 陈灏, 李智平*
作者信息 +

The Construction of Pediatric Prescription Knowledge Database Facilitates Prescription Pre-audit Intelligent Decision

  • WU Dan, XU Ying, ZHANG Xu-hui, ZHENG Feng, CHEN Hao, LI Zhi-ping*
Author information +
文章历史 +

摘要

目的 完善现有儿童合理用药知识库,用以降低儿童用药差错发生率,提高儿童药物治疗的安全性和有效性。方法 通过查阅相关资料构建儿童处方医嘱知识库,以此为基础,在医生开具医嘱和处方时自动推荐用法用量,并对医嘱及处方进行前置审核,按不同安全等级予以拦截。结果 2018年11月至2019年4月,前置审方系统共审核住院医嘱906 945条,由于儿童合理用药知识库的使用,住院医嘱中慎用,相对禁用和绝对禁用医嘱占总医嘱的比例分别从71.71%,5.45%和0.12%下降至35.86%,3.51%和0.08%,开嘱医生对系统的适应性和用药的合理性逐月提高。结论 儿童合理用药知识库的使用,显著降低了我院住院患儿用药差错的发生率,提高了医疗同质化水平,是值得考虑推广的医疗服务模式。

Abstract

OBJECTIVE To perfect China's pediatric knowledge database of rational medication use, to reduce the incidence of medication errors and to improve the safety and effectiveness of medication therapy in children. METHODS Construct the pediatric prescription knowledge database by accessing relevant handbooks, guidelines, online databases and researches, and embed it into the prescription pre-audit intelligent decision system. Based on this, the system could automatically recommend dosage and usage information to the physicians during prescribing, it could also pre-screen and intercept improper medical orders and prescriptions according to different security levels. RESULTS From November 2018 to April 2019, the prescription Pre-audit Intelligent Decision System reviewed a total of 906,945 inpatients orders. Due to the use of the Pediatric Prescription Knowledge Database, the inpatients' precaution, relative contraindication and absolute contraindications orders presented a remarkably decline, from 71.71%, 5.45% and 0.12% respectively, to 35.86%, 3.51% and 0.08%. The physician's fitness to the system and rationality of medication increased month by month. CONCLUSION The use of the Pediatric Prescription Knowledge Database significantly reduces the incidence of medication errors in hospitalized children and improves the level of medical homogenization. It is a medical service model worthy of consideration.

关键词

儿童 / 合理用药 / 知识库 / 前置审方 / 智能决策

Key words

pediatrics / rational medication use / database / prescription pre-audit / intelligent decision

引用本文

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吴丹, 徐颖, 张旭晖, 郑锋, 陈灏, 李智平. 我院儿童处方医嘱知识库建设与处方前置审核系统的运行实践[J]. 中国药学杂志, 2020, 55(12): 1046-1050 https://doi.org/10.11669/cpj.2020.12.015
WU Dan, XU Ying, ZHANG Xu-hui, ZHENG Feng, CHEN Hao, LI Zhi-ping. The Construction of Pediatric Prescription Knowledge Database Facilitates Prescription Pre-audit Intelligent Decision[J]. Chinese Pharmaceutical Journal, 2020, 55(12): 1046-1050 https://doi.org/10.11669/cpj.2020.12.015
中图分类号: R969.3   

参考文献

[1] GÓIS PAIXÃO M J. Interventions for reducing medication errors in children in hospitals[J]. Clin Nurse Spec, 2017, 31(2):77-78.
[2] KAUSHAL R, BATES D W, LANDRIGAN C, et al. Medication errors and adverse drug events in pediatric inpatients [J]. JAMA, 2001, 285(16):2114-2120.
[3] KUNAC D L, KENNEDY J, AUSTIN N, et al. Incidence, preventability, and impact of adverse drug events (ADEs) and potential ADEs in hospitalized children in New Zealand: a prospective observational cohort study[J]. Paediatr Drugs, 2009, 11(2):153-160.
[4] HOLDSWORTH M T, FICHTL R E, RAISCH D W, et al. Impact of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients[J]. Pediatr, 2007, 120(5):1058-1066.
[5] RISHOEJ R M, ALMARSDÓTTIR A B, CHRISTESEN H T, et al. Medication errors in pediatric inpatients: a study based on a national mandatory reporting system[J]. Eur J Pediatr, 2017, 176(12):1697-1705.
[6] GLANZMANN C, FREY B, MEIER C R, et al. Analysis of medication prescribing errors in critically ill children [J].Eur J Pediatr, 2015, 174(10):1347-1355.
[7] DAI T. International experiences of health decision support system development[J]. Chin J Evid-based Med(中国循证医学杂志), 2012, 12(3):247-250.
[8] LIU X Q, JIAO Z, GAO Y C, et al. Progress in development and application of decision-making systems for individualized dosing[J]. Chin Pharm J(中国药学杂志), 2019, 54(1):1-8.
[9] BELARD A, BUCHMAN T, FORSBERG J, et al. Precision diagnosis: a view of the clinical decision support systems (CDSS) landscape through the lens of critical care[J]. J Clin Monit Comput, 2017, 31(2):261-271.
[10] KUX B R, MAJEED R W, AHLBRANDT J, et al. Factors influencing the implementation and distribution of clinical decision support systems (CDSS) [J]. Stud Health Technol Inform, 2017, 243:127-131.
[11] RUANO M, VILLAMAÑÁN E, PÉREZ E, et al. New technologies as a strategy to decrease medication errors: how do they affect adults and children differently [J]. World J Pediatr, 2016, 12(1):28-34.
[12] ZANG J, CHEN N, LI J, et al. Design and operation practice of up-front prescription review/intervention system for outpatients in our hospital [J]. Chin Pharm J(中国药学杂志), 2019, 54(5):420-423.
[13] POIRIER T I, GIUDICI R A. Drug interaction microcomputer software evaluation: drug therapy screening system (DTSS) [J]. Hosp Pharm, 1990, 25(8):738-744.
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