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Injection Overuse Situation in Health Service Settings in Rural Area of Midwest Part of China

Objective　To explore the serious situation of injection abuse, and its influence to average prescription fee. Methods　The subjects of this study were health service settings in rural area of 9 provinces/cities in Midwest of China. The treatment prescription indicators of county and village health service settings were calculated. Results　Prescription injection rates of health care facility in rural area of Midwest provinces/cities of China (25.8% to 62.2%,mean: 45.1%) were higher than the standard of WHO (13.4% to 24.1%), and the injection abuse situation was serious. Injection bause caused the increase of prescription fee. Excess usage of injection in health service settings was related to the economic level of the on-site county or village, and also related to the size and load of health service facilities. Conclusion　Suggestions are proposed to the government health agency according to the results of the study: enhancing the lawmaking, establishing the related policy and effective measure, training the medical personnel, promoting the mass health education, investigating the effective injection management model in rural area, and reducing the rate of injection.

处方质量分析与风险防范

摘要: 本文通过回顾颁布实施的《处方管理办法》,结合我院门诊处方分析中存在的问题,浅析医院药师的法律责任,提出减轻或避免法律责任的防范措施,目的在于提高药师的职业风险意识和药学服务水平,促进合理用药。

The Analysis of Antibacterials Utilization for 400 Outpatients

目的:了解我院门诊部抗菌药物的使用情况,防止临床上滥用抗菌药。方法:随机抽取2008年成人普通处方,每季度100份,共计400份,统计所需分析数据。结果:抗菌药物的品种数占处方用药总品种数的1154%;抗菌药物的总金额占处方总金额的比率为1341%;注射剂使用率为4%;每张处方合并用药品种数269种;处方使用通用名为100%;抗真菌药物的使用率低于1%。结论:门诊患者抗菌药物使用合理。

门诊儿科处方不合理用药的调查与分析

【摘要】　目的　了解分析门诊儿科处方用药情况，促进合理用药。　方法　随机抽取2009年1-12月的门诊儿科处方10 800张，根据《医院处方点评管理规范（试行）》及文献资料，对不合理用药处方进行分类和统计。　结果　不合理用药主要表现为遴选的药品不适宜，药物联用不适宜，溶媒不合理，用法、用量不适宜等。　结论　儿科医师应更好地掌握药物相关知识，提高门诊儿科处方的合理用药水平。

医院常见不合理用药处方点评及防范

【摘要】　目的　对处方用药状况进行调查和点评，充分掌握临床容易出现的不合理处方，提醒药师、医师引起注意，减少不合理用药，提高合理用药水平，确保患者用药安全。　方法　对照《处方管理办法》、《医院处方点评管理规定管理（试行）》，收集崇州市人民医院2010年2-7月门诊、病区各科室不合理处方，结合药品说明书以及药师查阅的相关文献资料，对其不合理处方进行点评。　结果　不合理处方包括遴选的药品不适宜、适应证不适宜、用法用量不适宜、联合用药不适宜、重复给药、超常处方。　结论　合理用药不仅涉及药师、医师，同时涉及护士和患者。只有多方面参与，建立合理用药监督机制，努力开展临床药学监护，才能够提高合理用药水平，减少不合理用药现象的发生。

加强门急诊药师培训提高处方交待的准确性

摘要:处方交待是医院药学人员开展药学服务的主要形式,其提供给患者的科学性、通俗性,直接影响到患者用药的依从性和用药的有效性。本文就我院对门急诊药师培训的一系列内容进行总结。目的是提高药师解释医嘱的能力,让药师更好地指导患者合理使用和正确服用药物,使药物发挥应有的作用。

History of Drug Treatments Including Formularies,Current Situation and Strategy

Investigation and Analysis on the Effect of Special Rectification of Antibiotic Activities in Outpatient Department

ObjectiveTo investigate the status of antibiotic drug use in the outpatient department based on the special rectification activities of antibiotic drugs, identify the reasons for irrational use of antibiotic agents and propose the solutions. MethodsPrescription of antibiotic drugs were analyzed by a retrospective comparative analysis during April to June 2011, August to October 2011 and August to October 2012. ResultsPrescriptions of antibiotic drugs were 435 (36.25%), 367 (30.58%) and 223 (18.58%) during April to June 2011, August to October 2011 and August to October 2012, respectively, and the unreasonable prescriptions were 35 (2.92%), 27 (2.25%), and 14 (1.25%) respectively. ConclusionThere is a decreased tendency of prescription of antibiotic drugs in the outpatient department of our hospital because of the special rectification activities of antibiotic drugs. It is in accordance with antibiotic use rate of <20% target of "antibiotics in 2012 special rectification program" in hospital outpatient service. But there are some unreasonable phenomena in the use of antibiotics, and to promote the reasonable use of antibiotics, we should strengthen management.

The Effect of Using “Education Prescription” in the Evidence Retrieval Teaching Practice

Objective　To observing about how effect is the education prescription using by the medical students, looking into whether the manner can attach the students attention and improve on the retrieval ability for them. Methods　Choosing one of the cases come from PubMed and drawing out a clinical question. Asking total 100 students to search literature and write search strategy, search results and the reason about the results by chosen (similar to appraisal evidence), and their self-evaluation of this process. Results　Of the 100 students, 96 (96%) searched PubMed/MEDLINE, and 79 (79%) searched second research database, 28 (28%) searched Science Citation Index (Web of Science), 38 (38%) chosen one of ten articles according with the articles chosen by the overseas doctors. We found no students weren’t interesting in the education prescription, but 65 (65%) didn’t think the education prescription be easy achieved, at the same time they mentioned that the retrieval problems were solved or profited came from the practice. Conclusions　Filling education prescription can attract students attention and induct them to learn the basic concept of EBM, and to practice how to searching evidence and the feedback of students can help improve on teaching work.

Irrational prescriptions of antibiotics in Beijing Hospital from 2016 to 2019

ObjectiveTo evaluate the rationality of antibiotics use by analyzing the prescription reviewing results.MethodsThe review data of antibiotic prescriptions in Beijing Hospital was randomly selected from 2016 to 2019, from which unreasonable prescriptions and the antimicrobial agents were analyzed, and the use of antibiotics and unreasonable prescriptions annually were compared.ResultsThe evaluation of rational use of antibiotics involved 79 701 outpatient prescriptions from 2016 to 2019. There were 10 drugs in the top five irrational rates of outpatient antibiotics, primarily cephalosporin and quinolones, accounting for 50% and 30%, respectively. The primarily unreasonable problems were over prescription (common in gastroenterology and dermatology), unsuitable indications (common in otolaryngology), inappropriate usage and dosage (common in urology, dermatology and gastroenterology), and failure to write clinical diagnosis or incomplete clinical diagnosis (common in obstetrics and gynecology and general surgery). During the four years, the proportion of antibiotics prescriptions and the irrational rate decreased annually.ConclusionsThe use of antibiotics in outpatient department of Beijing Hospital has achieved initial results, however, there are still some problems. We should further strengthen the management of antibiotics usage, strengthen training and learning, and increase medical cooperation to promote rational drug use in clinic.