临床用药风险管理常见问题及应对措施

目的：对我院不安全用药行为进行监测与调查，分析临床用药问题中存在的风险因素，探讨医疗机构加强药品风险管理的措施，以减少临床用药的安全隐患。方法：采用调查问卷的方式，对我院部分科室就诊患者的用药情况进行问卷调查；应用“医院用药安全监测与评价”软件对我院医护人员在临床用药管理方面存在的风险因素进行评估，整理并分析调查结果。结果：在本次临床用药风险分析中，各因素所占比例为：医生：30.50%，药师：9.00%，护士：32.00%，患者：28.50%。了解临床用药各环节中存在的临床用药风险的医护人员占83.3%，但只有50.6% 的人员采取基本的防范措施。用药风险警示调查显示：PASS 警示有效率为57.5%；关联因素评价中人员因素的发生率最高55.16%；外界因素次之31.29%；药物因素发生率为26.95%。结论：医疗机构应当加强临床用药管理，识别、分析用药风险因素，强化合理用药意识及知识，努力构建临床用药风险控制系统，为医药护理人员及患者营造良好的医疗安全氛围，从而降低用药风险的发生，保障患者的用药安全。

Problems and Measures about the Management of Clinical Medicine Risks

Objective： To analyze the risk factors of clinical medication by means of detecting and inspecting the safe use behaviors of drugs in our hospital, and to explore the probable measures to strength the pharmaceutical risk management so that the security risks of the usage for drugs could be prevented. Methods： Patients that from major department in our hospital were selected to take the in- vestigation on the medication, and the hospital staff that from the representative sections were surveyed and evaluated by the ＂Hospital Drug Safety Monitoring and Evaluation＂ in terms of the drug risk warning and associated factors assessment. Then the investigative results were collected and analyzed. Results： The proportion of risk factors： Doctors, 30.50%; Pharmacists, 9.00%; Nurses, 32.00%; Pa- tients, 28.50%. There were 83.3% people that have the knowledge of health care of clinical medicine, but only 50.6% of the staff have the conscious of taking basic precautions. Medication risk warning survey has showed us that the PASS warning effective rate was 57.5%; the highest incidence that from patients was 55.16%; external factors followed by 31.29%; drugs were account for 26.95%. Conclusion： In order to prevent the incidence of drug risks, patients should take care of medication safety, medical institutions should strengthen the management of clinical medicine, identify and analyze the risks, strengthen the awareness and knowledge of the rational use of drugs as well as make efforts to build a system for medicine control, to create a good medical safety atmosphere for the pharmaceutical field.