临床药师对我院呼吸科人血白蛋白使用的干预效果评价

发布时间：2018-05-10 18:24

  本文选题：人血白蛋白 + 综合干预措施　； 参考：《中国药房》2017年32期

【摘要】：目的:评价实施综合干预措施对我院呼吸科人血白蛋白使用的影响,促进临床合理用药。方法:根据人血白蛋白说明书、相关指南及文献,按照循证药学方法建立我院呼吸科人血白蛋白使用评价标准,采取医嘱审核、处方点评、信息系统权限设置等技术措施和绩效考核手段对人血白蛋白的使用进行综合干预。调取2015年1-6月(干预前组,226例)、2016年1-6月(干预后组,148例)使用人血白蛋白的患者处方,对人血白蛋白总使用量、人均使用量、平均使用时间、适应证、禁忌证、合理性等进行统计分析,并比较干预前后两组患者人血白蛋白的使用情况。结果:患者的人血白蛋白总使用量、人均使用量、平均使用时间分别由干预前的18 350 g、(81.2±71.3)g、(7.8±7.2)d,下降至干预后的7 584 g、(51.2±48.3)g、(4.7±2.1)d;患者使用人血白蛋白不符合《人血白蛋白、非蛋白胶体溶液及晶体溶液使用指南》规定的适应证比例、违背禁忌证使用人血白蛋白的比例分别由干预前的80.1%、50.0%下降至干预后的39.9%、16.9%;用药前血清白蛋白浓度≥35 g/L、≥30~35 g/L、≥20~25 g/L组患者人数干预前组明显多于干预后组,20 g/L、≥20~25 g/L组患者人数干预后组明显多于干预前;合理使用人血白蛋白的患者比例由干预前的16.8%上升至干预后的52.7%,以上指标干预前后比较,差异均有统计学意义(P0.05)。结论:综合干预措施可有效降低人血白蛋白在适应证、疗程等方面的不合理使用及比例等,提高临床合理使用水平。
[Abstract]:Objective: to evaluate the effect of comprehensive intervention on the use of human serum albumin (HSA) in respiratory department. Methods: according to the instruction of human serum albumin (HSA), the related guidelines and literatures, and according to the method of evidence-based pharmacology, the evaluation standard of human serum albumin in respiratory department of our hospital was established, and the doctors' orders were examined and the prescriptions were evaluated. Technical measures, such as information system authority setting and performance evaluation, were used to comprehensively intervene in the use of human serum albumin (HSA). From January to June 2015 (226 patients in the pre-intervention group and 148 patients in the post-intervention group), the total usage of human serum albumin, average usage per capita, average time of use, indications, contraindications and contraindications were obtained. The rationality was statistically analyzed and the use of human serum albumin was compared between the two groups before and after intervention. Results: the total usage of human serum albumin, the per capita usage, and the average time of use were decreased from 81.2 卤71.3 g / d before intervention to 7 584 g / L 51.2 卤48.3 g / d after intervention and 4.7 卤2.1 / d after intervention, respectively, and the mean time of using human serum albumin was not in accordance with < human serum albumin (HSA). The proportion of indications specified in the guidelines for the use of nonprotein colloidal solutions and crystal solutions, The proportion of using human serum albumin before intervention decreased from 80.1% to 39.9% after intervention, and the concentration of serum albumin was more than 35 g / L, 鈮，

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