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美国卫生系统药师协会医院药学实践全国性调查:处方开具与转录——2001年

ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing--2001.

作者信息

Pedersen C A, Schneider P J, Santell J P

机构信息

College of Pharmacy, Ohio State University, 500 West 12th Avenue, Columbus, OH 43210-1291, USA.

出版信息

Am J Health Syst Pharm. 2001 Dec 1;58(23):2251-66. doi: 10.1093/ajhp/58.23.2251.

Abstract

Results of the 2001 ASHP national survey of pharmacy practice in hospital settings that pertain to prescribing and transcribing are presented. A stratified random sample of pharmacy directors at 1091 general and children's medical-surgical hospitals in the United States was surveyed by mail. SMG Marketing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn from SMG's hospital database. The response rate was 49.0%. During 2001, nearly all hospitals are estimated to have pharmacy and therapeutics (P&T) committees that meet an average of seven times per year. It is estimated that more than 90% of P&T committees are responsible for formulary development and management, drug policy development, adverse-drug-reaction review, and medication-use evaluation. More than 90% of hospitals use clinical and therapeutic, cost, and pharmacoeconomic information in the formulary management process, while nearly two thirds consider quality-of-life issues. Nearly 70% use clinical practice guidelines in the formulary management process, and 78% have a medication-use evaluation program designed to improve prescribing. Pharmacists in more than 75% of hospitals provide consultations on drug information, dosage adjustments for patients with renal impairment, antimicrobials, and pharmacokinetics. Further, a majority of hospitals ensure accurate transcription of medication orders by clarifying illegible orders before transcription or entry into medication administration records (MARs), using standardized prescriber order forms, requiring prescribers to countersign all oral orders, and reconciling MARs and pharmacy patient profiles at least daily. In 2001, large hospitals are most likely to use prescriber order-entry systems to improve patient safety and are least likely to require the reentry of medication orders into the pharmacy computer system. The 2001 ASHP survey results suggest that pharmacists in hospital settings have positioned themselves well to improve the prescribing and transcribing components of the medication-use process.

摘要

本文呈现了2001年美国卫生系统药师协会(ASHP)针对医院环境中与处方开具及转录相关的药学实践进行的全国性调查结果。通过邮件对美国1091家综合及儿童内科-外科医院的药房主任进行了分层随机抽样调查。SMG营销集团提供了医院特征数据;调查样本取自SMG的医院数据库。回复率为49.0%。2001年期间,估计几乎所有医院都设有药学与治疗学(P&T)委员会,这些委员会平均每年开会7次。据估计,超过90%的P&T委员会负责处方集的制定与管理、药物政策制定、药物不良反应审查以及用药评估。超过90%的医院在处方集管理过程中使用临床与治疗、成本以及药物经济学信息,而近三分之二的医院会考虑生活质量问题。近70%的医院在处方集管理过程中使用临床实践指南,78%的医院设有旨在改善处方开具的用药评估项目。超过75%的医院的药师会就药物信息、肾功能不全患者的剂量调整、抗菌药物以及药代动力学提供咨询。此外,大多数医院通过在转录或录入用药管理记录(MARs)之前澄清难以辨认的医嘱、使用标准化的处方医师医嘱表单、要求处方医师会签所有口头医嘱以及至少每天核对MARs与药房患者档案来确保用药医嘱的准确转录。2001年,大型医院最有可能使用处方医师医嘱录入系统来提高患者安全性,而最不可能要求将用药医嘱重新录入药房计算机系统。2001年ASHP的调查结果表明,医院环境中的药师已做好充分准备,以改善用药过程中的处方开具及转录环节。

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