Practice and effect evaluation of refined setting of evidence-based reference prescription pre-audit rules in anesthesiology department
OBJECTIVE To optimize the pre-audit rules for anesthesia prescriptions,improve the audit quality and rational drug use.METHODS The inpatient medical orders of anesthesia department from prescription pre-audit system of the Affiliated Hospital of Qingdao University(hereinafter referred to as"our hospital")were analyzed from April 1 to 30,2023.The classification statistics and evidence-based inquiry were carried out for irrational drug use issues;combined with our hospital's current implementation of the Anesthesiology Clinical Pathway Medication Standards,the audit rules were set in details,and audit management and communication feedback processes were established.The total number of monthly audited orders,the number of pre-audit pop ups,system interception rate,physician modification rate after system audit,pharmacist audit rate,and reasonable rate of medical orders after refined setting of rules(May-December in 2023)were compared with before setting(April in 2023);the average medication cost per anesthesia session after refined setting of rules was also compared with before setting(May-December in 2022).RESULTS Irrational drug use in the anesthesia department mainly included inappropriate indications,inappropriate administration routes,inappropriate usage and dosage,inappropriate compatibility,medication problems in special populations,and improper medication during the perioperative period.After the refinement of the rules,the number of pre-audit pop ups in the anesthesia department significantly decreased over time,and gradually reached a stable state after continuous improvement.Compared with before setting,the system interception rate after the refinement of rules(P＜0.001),physician modification rate after system audit(P＜0.001)both increased significantly,while the pharmacist audit rate significantly decreased(P＜0.001).There was a linear trend between the reasonable rate of medical orders and the month from May to December in 2023(P＜0.05).Compared with before the setting,the average medication cost of anesthesia per session decreased from 720.72 yuan to 528.21 yuan,with a decrease of 26.71%.CONCLUSIONS Based on evidence-based reference,refining pre-audit rules for anesthesia prescriptions can significantly improve the quality of prescription examination,promote rational drug use,and save patient's medical expenses.
prescription pre-auditanesthesia departmentevidence-based referenceaudit rulesrational drug use
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