Analysis of 694 irrational medical instructions in pharmacy intravenous admixture services

Abstract

Objective To fully analyze irrational medical instructions in pharmacy intravenous admixture services(PIVAS) from various scope or aspect for promoting rational use of clinical drugs. Methods The data of medical instructions in the PIVAS of our hospital were collected and straightened out from January, 2017 to December, 2018. And the cases of irrational medical instructions were studied further by using the frequency and percentage composition by descriptive analysis methods. Results Six hundred and ninety-four irrational instructions, which were composed of 736 errors and involved a total of 132 kinds of drugs, were found. The irrational instructions were classified as amount of solvent, solvent, frequency of medication, dosage, operational error, unreasonable compatibility, and others. And their values of frequency, the percentage composition, and the type of drug involved were 213, 28.94%, and 53; 186, 25.27%, and 37; 94, 12.77%, and 16; 74, 10.05%, and 32; 133, 18.07%, and 66; 30, 4.08%, and 16; and 6, 0.82%, and 5, respectively, according to previous order. The frequencies and percentage compositions of irrational medical instructions in the top 10 drugs involved were as follow: 44 groups (6.34%) of fat-soluble vitamin(Ⅱ)/water-soluble vitamin, 39 groups (5.62%) of adenosine monophosphate (0.5g), 36 groups (5.19%) of Melon smut injection [4 ml], 34 groups (4.90%) of cefoperazone tazobactam [2.5 g], 32 groups (4.61%) of piperacillin sulbactam [0.75 g], 32 groups (4.60%) of Shuganning [2 ml], 24 groups (3.46%) of doxofylline injection [0.2 g: 20 ml] ,24 groups (3.46%) of cefoperazone tazobactam [2.0 g], 21 groups (3.03%) of Mannan peptide (water) [5 mg: 2 ml], and 19 groups (2.74%) of compound glycyrrhizin [20 mg]. These irrational medical instructions accounted for 42.95% (340/694) of all. The types of irrational medical instructions and drugs involved were obvious different in various kinds of clinical departments. Conclusion It is essential to improve clinical rational medication that medical review ability of pharmacist must be strengthened and appropriate intervention measures implemented according to the characteristics of each clinical department. Key words: Pharmacy intravenous admixture services(PIVAS); Irrational medical instructions; Descriptive analysis