Design And Application Of Rational Medication Monitoring And Intervention System

Objective: Based on the hospital information system(HIS), rational medication monitoring and intervention system was designed and developed through object language of Power Builder and Oracle 10 database technology. This system was set to monitor indicators of rational administration and intervene in irrational drug use if any, improve the management efficiency of rational medication in hospital.Methods:(1) To establish “evaluation criteria of prophylactic antibacterials in surgery " and “evaluation criteria of therapeutic antibacterials", and conduct a retrospective survey of 369 discharged patients, so as to investigate the clinical index of rational medication of antibiotics and its status.(2) To extract and sort the ratios of adjuvant drugs in the total drug consumption based on HIS. Totally, 180 adjuvant medical records were selected in stratified random and investigated retrospectively by drug names.(3) To formulate the software developing process through collaboration of hospital management experts, infection management experts, clinical pharmacists and software engineers. Based on the state policy of rational medication management, monitoring indicators and intervention contents and rules were set in light of the actual hospital management.(4) To determine the management index of antibacterial medication and count up the ratios of adjuvant drugs in total drug consumption from 2012 to 2015 through the rational medication monitoring and intervention system. Therefore, the influence of our established system on clinical rational medication would be understood via the index change.Results:(1) In early time of antibiotics specific rectification in a hospital, there was a big gap between the target and actual values of clinical application of antibacterials. Meanwhile, irrational rates of surgical prophylactic medication and therapeutic medication were 79.8% and 31.3%, respectively. The irrational medications were mainly found in cases of improper treatment course, bad timing of drug administration, and inappropriate choice of medicines, etc.(2) The consumptions of adjuvant drugs were in the forward ranks, occupying 5 of top 10 drugs. And the irrational rate of adjuvant drug clinical application was 24.4%, in which the rates of improper indications and inadvisable dosage dominated.(3) With friendly interface, the rational medication monitoring and intervention system was able to monitor 25 indicators and intervene in combinational therapy of antibiotics, surgical prophylaxis and adjuvant medication. Users can set 4 management levels in system, including "reminder", "explanation", "approval" and "prohibition", so as to manage the irrational medication freely.(4) During the operation of the system, the rational drug use index and the adjuvant drug index were obviously improved, and the intervention effect was obvious.Conclusion:The rational medication monitoring and intervention system showed perfect function with management flexibility and good extensibility. The system can well monitor and intervene irrational drug administration, and therefore it is worthy of popularization and further application.