Beauclair T R, Stoner C P
Am J Hosp Pharm. 1986 Mar;43(3):671-6.
A retrospective chart audit evaluating the degree of adherence of health-care personnel to guidelines for continuous intravenous infusion of morphine sulfate was conducted. The audit was conducted one year after implementation of guidelines for administering morphine sulfate by continuous i.v. infusion. Audit criteria were developed from these guidelines and used to evaluate justification of use, adherence of physicians, pharmacists, and nurses to procedures, and patient outcome. Audits were completed for 11 of 13 patients who received morphine sulfate infusions during the one-year study period. All patients met the standard for justification of use. Adequate patient outcome, defined as chart-documented pain relief within 24 hours, was achieved in six patients. The median time to pain control was 20 hours (range 4-168 hours). Physicians' and pharmacists' adherence to the guidelines was acceptable in over 80% of patients, but documentation of hourly monitoring of blood pressure and respiratory rate and rhythm by nurses met the standard in only 55% of patients; this may have been related to lack of a designated place in the chart for recording this information. The morphine sulfate infusion guidelines appear to contribute to safe and effective therapy.
开展了一项回顾性病历审核，以评估医护人员对硫酸吗啡持续静脉输注指南的遵守程度。该审核在通过持续静脉输注方式使用硫酸吗啡的指南实施一年后进行。审核标准依据这些指南制定，用于评估用药合理性、医生、药剂师和护士对操作程序的遵守情况以及患者的治疗结果。在为期一年的研究期间接受硫酸吗啡输注的13例患者中，有11例完成了审核。所有患者均符合用药合理性标准。6例患者实现了充分的患者治疗结果，即病历记录显示在24小时内疼痛缓解。疼痛控制的中位时间为20小时（范围4 - 168小时）。医生和药剂师对指南的遵守情况在超过80%的患者中是可接受的，但护士对血压、呼吸频率和节律进行每小时监测的记录仅在55%的患者中符合标准；这可能与病历中缺乏记录该信息的指定位置有关。硫酸吗啡输注指南似乎有助于实现安全有效的治疗。
