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孙雯娟, 邹羽真, 张凡, 张路, 赵林, 白春梅, 张锋, 徐燕, 茅枫, 李菁, 顾宇, 范欣荣, 王孟昭, 周道斌, 张占杰, 赵彬, 杜小莉, 张波, 孙学勤, 龙笑, 常青, 胡冰水, 潘慧, 吴文铭. 抗肿瘤药物安全管理系统的建立与运行效果分析[J]. 协和医学杂志, 2022, 13(3): 461-467. DOI: 10.12290/xhyxzz.2021-0704
引用本文: 孙雯娟, 邹羽真, 张凡, 张路, 赵林, 白春梅, 张锋, 徐燕, 茅枫, 李菁, 顾宇, 范欣荣, 王孟昭, 周道斌, 张占杰, 赵彬, 杜小莉, 张波, 孙学勤, 龙笑, 常青, 胡冰水, 潘慧, 吴文铭. 抗肿瘤药物安全管理系统的建立与运行效果分析[J]. 协和医学杂志, 2022, 13(3): 461-467. DOI: 10.12290/xhyxzz.2021-0704
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SUN Wenjuan, ZOU Yuzhen, ZHANG Fan, ZHANG Lu, ZHAO Lin, BAI Chunmei, ZHANG Feng, XU Yan, MAO Feng, LI Jing, GU Yu, FAN Xinrong, WANG Mengzhao, ZHOU Daobin, ZHANG Zhanjie, ZHAO Bin, DU Xiaoli, ZHANG Bo, SUN Xueqin, LONG Xiao, CHANG Qing, HU Bingshui, PAN Hui, WU Wenming. Design and Analysis of the Operation Effect of the Safety Management System for Antitumor Drugs[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(3): 461-467. DOI: 10.12290/xhyxzz.2021-0704
Citation: SUN Wenjuan, ZOU Yuzhen, ZHANG Fan, ZHANG Lu, ZHAO Lin, BAI Chunmei, ZHANG Feng, XU Yan, MAO Feng, LI Jing, GU Yu, FAN Xinrong, WANG Mengzhao, ZHOU Daobin, ZHANG Zhanjie, ZHAO Bin, DU Xiaoli, ZHANG Bo, SUN Xueqin, LONG Xiao, CHANG Qing, HU Bingshui, PAN Hui, WU Wenming. Design and Analysis of the Operation Effect of the Safety Management System for Antitumor Drugs[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(3): 461-467. DOI: 10.12290/xhyxzz.2021-0704
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抗肿瘤药物安全管理系统的建立与运行效果分析

Design and Analysis of the Operation Effect of the Safety Management System for Antitumor Drugs

    摘要
  • 摘要:
      目的  设计抗肿瘤药物安全管理系统, 从处方源头拦截超剂量医嘱, 保障抗肿瘤药物临床应用的安全性。
      方法  制订88种抗肿瘤药物阈值拦截/警示策略, 建立抗肿瘤药物安全管理系统, 对超剂量抗肿瘤药物医嘱进行拦截/警示。调取2021年1—6月抗肿瘤药物安全管理系统中的拦截/警示数据并进行统计分析。
      结果  抗肿瘤药物安全管理系统共拦截/警示医嘱665条, 其中触发拦截功能的医嘱共642条(96.54%), 触发警示功能的医嘱共23条(3.46%); 拦截/警示的药品以口服片剂为主(74.29%); 被拦截医嘱中, 频次错误占比最高(64.22%), 其次为途径错误(11.73%)和剂量错误(9.92%)。拦截超剂量医嘱564条, 涉及抗肿瘤药物28种; 拦截次数最多的抗肿瘤药物为甲氨蝶呤片, 平均超剂量7倍; 注射用培美曲塞二钠平均超剂量倍数排名第1, 平均超剂量1000倍。拦截超途径医嘱78条, 涉及5种抗肿瘤药物。
      结论  抗肿瘤药物安全管理系统从处方环节杜绝了医嘱超剂量用药错误, 切实保障了抗肿瘤药物的用药安全。

     

    Abstract:
      Objective  To design a safety management system for antitumor drugs, which can intercept or warn the overdose of medical orders from the prescription source, and ensure the safety of clinical application of antitumor drugs.
      Methods  The threshold of interception and warning strategy of 88 kinds of antitumor drugs were developed, and the safety management system of antitumor drugs was established to intercept or warn the overdose orders. The interception and warning data from January 2021 to June 2021 in the safety management system of antitumor drugs were extracted and analyzed.
      Results  A total of 665 medical orders were intercepted or warned by the safety management system of antitumor drugs, and the majority of the intercepted or warned drugs were oral tablets(74.29%). The intercepted orders were 642 (96.54%), and the warned orders were 23(3.46%). Among the intercepted medical orders, frequency error (64.22%) has the highest proportion, followed by route error (11.73%) and dose error (9.92%). A total of 564 medical orders were intercepted, involving 28 kinds of antitumor drugs. Methotrexate tablets ranked first in overdose quantity, with an average of seven times. Pemetrexed ranked first in overdose multiples, with an average overdose of 1000 times. 78 medical orders were intercepted for over pathway, involving 5 kinds of antitumor drugs.
      Conclusion  The safety management system of antitumor drugs can eliminate the error of overdose in prescription and guarantee the safety of antitumor drugs.

     

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