Analysis of Interception of Irrational Medical Orders by the Prescription Pre-Review System of Outpatient and Emergency in a Hospital
Objective To promote the safe and rational use of drugs in clinical practice.Methods The medical orders involving western medicines reviewed by the prescription pre-review system of outpatient and emergency in the Beijing Jishuitan Hospital,Capital Medical University from November 2022 to October 2023 were collected,and the rationality of medical orders was analyzed.Results A total of 3 230 289 medical orders were collected,of which 68 730 were irrational(2.13% );the irrational medical orders were mainly induced by inappropriate indications(49 162 cases,71.53% ),followed by repeated medication(9 629 cases,14.01% ),and the others were all induced by general irrationality,including inappropriate usage and dosage,incompatibility of drugs/adverse drug-drug interactions,inappropriate drug selection,inappropriate drug dosage form/administration route and inappropriate multiple factors.The inappropriate indications were mainly induced by some physicians' unfamiliarity with the indications of newly-added drugs in the hospital and false positives in the system judgment.The repeated medication were mainly induced by some physicians' unfamiliarity with the active ingredients,functions and indications of some compound preparation due to their complexity and the false positives caused by sequential treatment regimen.Conclusion The application of prescription pre-review system can effectively avoid the medication errors and decrease the irrational medication costs.For the false positives and false negatives in the system judgment,hospitals need to constantly update and improve the database;pharmacists should continuously increase their professional knowledge,and closely cooperate with physicians to continuously improve the quality of medical order review and promote the rational drug use in clinical practice.
prescription pre-review systemoutpatient and emergencywestern medicineirrational medical orderPareto diagramrational drug use
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