目的:探讨综合干预促进门诊静脉输液合理率提高的效果.方法:某三级甲等医院(以下简称"该院")于2015年5月开展门诊输液情况调查及综合整治,故抽取2015—2016年第1季度各季度1个工作日的门诊处方,各季度处方分别为7408、7241、7088、7500、7697张,筛选其中静脉输液处方,分析构建多部门综合干预对各季度静脉输液率、不合理静脉输液率及抗菌药物使用情况的影响.结果:经过综合干预,门诊静脉输液率逐步降低,由2015年第1季度(干预前)的3.21%降至2016年第1季度的2.26%,不合理静脉输液率由2015年第1季度(干预前)的28.57%降至2016年第1季度的9.77%,差异均有统计学意义(P<0.05);抗菌药物联合使用率明显降低,抗菌药物品种选择趋于合理,非限制使用级抗菌药物使用率明显升高,差异均有统计学意义(P<0.05).结论:该院门诊静脉输液存在一定的不合理情况,多部门综合干预模式有助于提高门诊静脉输液合理率,促进合理用药,值得推广.
OBJECTIVE:To probe into the role of comprehensive intervention in promoting the qualification rate of outpatient intravenous infusion .METHODS: Investigation and comprehensive intervention were conducted on outpatient intravenous infusion prescriptions from one grade A class-three hospital ( hereinafter referred to as "the hospital") in May 2015, the prescriptions of workday in each quarter were sampled in outpatient department were extracted during 2015-2016, respectively 7408 prescriptions, 7241 prescriptions, 7088 prescriptions, 7500 and 7697 prescriptions; of which the intravenous infusion prescriptions were screened .Analysis was conducted on the effects of comprehensive intervention on variation of proportions of the infusion , irrational intravenous infusion rate of prescriptions and the application of antibiotics . RESULTS: After comprehensive intervention , the rate of outpatient intravenous infusion decreased significantly from 3.21%the first quarter ( before intervention ) in 2015 to 2.26%the first quarter in 2016.The irrational rate decreased from 28.57% the first quarter ( before intervention ) in 2015 to 9.77% the first quarter in 2016, with statistically significant difference (P<0.05).The combination rate of antibiotics decreased significantly , the selection of antibiotics tend to be rational , the application rate of antibiotics with restrictions on the use of level increased significantly , with statistically significant difference (P<0.05).CONCLUSIONS: There are some irrational phenomenon in outpatient intravenous infusion prescriptions of the hospital .Comprehensive intervention should be took to improve the rational rate of outpatient intravenous infusion prescriptions and promote the rational drug use .It is worthy of application and promotion .