Construction of an Asynchronous Mode of Inpatient-Order Pre-Prescription Review and Its Application Effect
Objective To construct an asynchronous mode of inpatient-order pre-prescription review(referred to as asynchronous prescription review mode),and to evaluate its application effect.Methods The prescription review center combined with the medical department,nursing department,information department,and other departments,based on the characteristics of inpatient order issuance and circulation,a nurse station review process was added to the synchronous mode of inpatient-order prescription review,and an asynchronous prescription review mode with"nurse station"and"prescription review center"was constructed.The hospital prescription review system data from October to December 2022(synchronous prescription review mode)and January to September 2023(asynchronous prescription review mode)were selected,the changes in the prescription review process before and after the improvement of the prescription review mode were compared,including whether problem orders are locked,the number of orders reviewed by pharmacists,the time limit of system review timeout(referred to as timeout),pharmacists'prescription review time,and the number of problem orders passed after timeout.Statistical analysis was conducted on the changes in quality control data of prescription review under asynchronous prescription review mode,including the number of pharmacist review orders,intervention modification rate,and order interception rates of false positive and false negative problems.The intervention types and reasons for problem orders were analyzed.Results Compared with the synchronous prescription review mode,the asynchronous prescription review mode temporarily stored problematic medical orders in the nurse station during pharmacist prescription review.The pharmacists'prescription review time was significantly longer(P＜0.001),and the pass rate of problem orders was significantly lower(2.25％vs.12.63％,P＜0.001).After implementing the asynchronous review mode,the main review modules of the system increased from 5 to 9,the number of pharmacists'reviews orders increased from 412 to 1 154 per month,the intervention modification rate increased from 75.39％to 80.86％,the interception rate of false negative orders decreased from 0.091％to 0.030％,but the interception rate of false positive orders increased from 14.00％to 15.54％.Among the types of intervention problem orders,the proportion of usage and dosage(40.73％),and repeated medication(20.36％)was relatively high.The intervention modification rates for diagnosis and medication issues(58.57％),and inappropriate combination therapy(61.18％)were relatively low.Conclusion Asynchronous prescription review mode can help physicians to issue medical orders more smoothly,assist pharmacists in carrying out rational drug use work better,and improve the quality of inpatient prescription review work.
万方数据
维普
