BEIJING, March 4 (Xinhua)-The website of the Ministry of Health recently released the Management Specification for Hospital Prescription Review (Trial) and the Specification.
Hospitals above Grade III are required to gradually establish and improve a special prescription review system to review the use of specific drugs or specific diseases. Doctors with irregular prescriptions, improper prescriptions and abnormal prescriptions will be given criticism and education until they leave their posts.
The following is the full text:
Hospital Prescription Review Management Standard (Trial)
Chapter I General Principles
Article 1 In order to standardize hospital prescription reviews, improve prescription quality, promote rational drug use, and ensure medical safety, this specification is formulated in accordance with the Drug Administration Law, the Law on Medical Practitioners, the Regulations on the Administration of Medical Institutions, the Prescription Administration Measures and other relevant laws, regulations and rules.
Article 2 Prescription review is a process of evaluating the standardization of prescription writing and the clinical applicability of drugs (indications, drug selection, route of administration, usage and dosage, drug interaction, compatibility contraindications, etc.). ), find existing or potential problems, formulate and implement intervention and improvement measures to promote clinical rational drug use.
Article 3 Prescription review is an important part of hospital's continuous medical quality improvement and drug clinical application management, and an important means to improve the level of clinical drug treatment. Hospitals at all levels shall, in accordance with this specification, establish and improve a systematic, standardized and continuously improved prescription review system, carry out prescription review work, and constantly improve it in practice.
Prescription reviews of other medical institutions at all levels and types shall be implemented with reference to this specification.
Article 4 Hospitals should strengthen the management of prescription quality and clinical application of drugs, standardize doctors' prescription behavior, and implement relevant regulations such as prescription review, drug distribution, check and medication ledger. Regularly train and educate medical staff on rational drug use; Formulate and implement continuous quality improvement measures.
Chapter II Organization and Management
Article 5 The hospital prescription review shall be organized and implemented by the hospital medical management department and pharmacy department under the leadership of the hospital drug and therapeutics committee (group) and the medical quality management committee.
Article 6 A hospital shall, according to the nature, functions, tasks and department settings of the hospital, set up a prescription review expert group composed of hospital pharmacy, clinical medicine, clinical microbiology, medical management and other multidisciplinary experts under the Medical and Therapeutics Committee (group) to provide professional technical advice for prescription review.
Seventh hospital pharmacy department should set up a prescription review working group, responsible for the specific work of prescription review.
Article 8 The members of the prescription review working group shall meet the following conditions:
(1) Having rich clinical experience and knowledge of rational drug use;
(2) Having corresponding professional and technical qualifications: the members of the working group for prescription review in hospitals above Grade II should have the qualifications for pharmaceutical professional and technical positions above Intermediate Level, and the members of the working group for prescription review in other hospitals should have the qualifications for pharmaceutical professional and technical positions above Pharmacist Level.
Chapter III Implementation of Prescription Review
Article 9 The pharmacy department of a hospital shall, in conjunction with the medical administration department, determine the specific sampling method and sampling rate according to the actual situation of the hospital's diagnosis and treatment subjects, department settings, technical level, diagnosis and treatment volume, among which the sampling rate of outpatient and emergency prescriptions shall not be less than 1‰ of the total prescriptions, and the absolute number of prescriptions audited every month shall not be less than100; The sampling rate of medical orders in wards (districts) (based on the number of discharged medical records) shall not be less than 1%, and the absolute number of discharged medical records shall not be less than 30 per month.
Article 10 The hospital prescription review team randomly selects prescriptions according to the determined prescription sampling method, and reviews outpatient and emergency prescriptions according to the prescription review worksheet (attachment); Ward (district) medication orders should be based on the patient's medical records, the implementation of comprehensive opinions, opinions by the hospital according to the actual situation of our hospital.
Eleventh hospitals above the third level should gradually establish and improve the special prescription audit system. Special prescription review refers to the prescription review of specific drugs or drugs for specific diseases (such as national essential drugs, blood products, traditional Chinese medicine injections, parenteral nutrition preparations, antibacterial drugs, adjuvant therapy drugs, hormones, etc.). According to the current situation and existing problems of pharmaceutical affairs management and clinical application management.
Twelfth prescription review work should adhere to the principles of science, justice and pragmatism, with complete and accurate written records, and notify the clinical departments and parties.
Thirteenth prescription review team found unreasonable prescriptions in the process of prescription review, it shall promptly notify the pharmaceutical management department and the pharmaceutical department.
Fourteenth conditional hospitals should use information technology to establish a prescription review system, and gradually realize networking and information sharing with hospital information systems.
Chapter IV Prescription Review Results
Fifteenth prescription review results are divided into reasonable prescriptions and unreasonable prescriptions.
Article 16 Unreasonable prescriptions include nonstandard prescriptions, inappropriate prescriptions and abnormal prescriptions.
Seventeenth in any of the following circumstances, it should be judged as non-standard prescription:
(a) the contents of the preface, text and postscript of the prescription are missing, and the writing is irregular or unclear;
(2) The signature or seal of the doctor is not standardized or inconsistent with the signature or seal sample;
(3) Pharmacists failed to review the suitability of prescriptions (the columns of review, deployment, check and dispensing of prescription postscript failed to review the signature of deployment pharmacists and check the signature of dispensing pharmacists, or the provisions of double signature were not implemented for single-person duty dispensing);
(four) the prescription of newborns and infants does not indicate the date and age;
(5) Western medicine, Chinese patent medicine and Chinese herbal pieces are not prescribed separately;
(6) Prescribing without using the name of the drug instruction;
(seven) the dosage, specification, quantity and unit of the drug are not standardized or clear;
(8) Usage and dosage of vague terms such as "following doctor's advice" and "for personal use";
(nine) the prescription is not signed and the date of revision is indicated, or the reason of drug overdose is not indicated and signed again;
(ten) the prescription is not written or the clinical diagnosis is incomplete;
(eleven) a single outpatient emergency prescription of more than five drugs;
(12) Under no special circumstances, the prescription dosage for outpatient service exceeds 7 days, the prescription dosage for emergency service exceeds 3 days, and chronic diseases, senile diseases or special circumstances need to extend the prescription dosage appropriately without indicating the reasons;
(thirteen) the prescription of narcotic drugs, psychotropic drugs, toxic drugs for medical use, radioactive drugs and other special management drugs did not implement the relevant provisions of the state;
(fourteen) the doctor did not prescribe antibacterial drugs in accordance with the "Regulations on the Administration of Clinical Application of Antibacterials";
(15) Prescription drugs for Chinese herbal pieces are not arranged in the order of "monarch, minister, assistant and envoy", or special requirements such as dispensing and decocting are not marked as required.
Article 18 Under any of the following circumstances, it shall be judged that the drug is not suitable for prescription:
(a) inappropriate display;
(2) The selected drugs are inappropriate;
(3) The dosage form or route of administration of the drug is inappropriate;
(4) Failing to give priority to the use of national essential drugs without justifiable reasons;
(5) Improper usage and dosage;
(six) the combination of drugs is not suitable;
(7) repeated administration;
(eight) there is incompatibility or adverse interaction;
(9) Other inappropriate drugs.
Article 19 In any of the following circumstances, it shall be judged as very prescription:
1. No indication;
2. Prescribing high-priced drugs without justifiable reasons;
3. Using drugs beyond the instructions without justifiable reasons;
4. Prescribing two or more drugs with the same pharmacological effects for the same patient at the same time without justifiable reasons.
Chapter V Application and Continuous Improvement of Evaluation Results
Twentieth hospital pharmacy department shall, in conjunction with the medical management department, review the review results submitted by the prescription review team, regularly publish the results of prescription review, and notify the unreasonable prescriptions; According to the results of prescription review, summarize and comprehensively analyze and evaluate the problems existing in hospital pharmacy management, prescription management and clinical medication, put forward quality improvement suggestions, and report them to the hospital drug and therapeutics Committee (group) and medical quality management Committee; If it is found that it may cause damage to patients, measures should be taken in time to prevent the occurrence of damage.
Article 21 The professional committee (group) of hospital pharmacology and therapeutics and the medical quality management committee shall, according to the quality improvement suggestions submitted by the pharmaceutical department in conjunction with the medical management department, study and formulate targeted improvement measures for clinical drug quality management and pharmaceutical affairs management, guide relevant departments to implement quality improvement measures, improve the level of rational drug use and ensure the safety of patients' drug use.
Twenty-second health administrative departments at all levels and doctors' regular assessment institutions should take the prescription review results as an important index into the hospital evaluation and doctors' regular assessment index system.
Twenty-third hospitals should incorporate prescription review results into the performance appraisal and annual appraisal indicators of relevant departments and their staff, and establish and improve relevant reward and punishment systems.
Chapter VI Supervision and Administration
Twenty-fourth health administrative departments at all levels should strengthen the supervision and management of prescription reviews in hospitals within their jurisdiction, and order hospitals that do not carry out prescription reviews according to regulations to make corrections.
Twenty-fifth health administrative departments and hospitals should take measures such as education, training and criticism for doctors who prescribe unreasonable prescriptions; If a doctor prescribes an abnormal prescription, it shall be handled in accordance with the provisions of the Prescription Management Measures; Doctors who prescribe unreasonable prescriptions for more than 5 times in an assessment cycle are regarded as unqualified doctors who are regularly assessed and leave their posts to participate in training; If serious damage is caused to patients, the health administrative department shall give corresponding punishment in accordance with relevant laws, regulations and rules.
Twenty-sixth pharmacists failed to review prescriptions, adjust drugs, explain drugs or effectively interfere with unreasonable prescriptions, hospitals should take measures such as education, training and criticism; If serious damage is caused to the patient, the health administrative department shall give corresponding punishment according to law.
Twenty-seventh hospitals cause damage to patients due to unreasonable drug use, and it shall be handled in accordance with relevant laws and regulations.