약사의 중재활동에 의한 약반납 감소효과에 관한 연구

Abstract

The prescriptions and dispenses for inpatients are conducted on a daily basis at Seoul National University Hospital (SNUH). The prescriptions for inpatients are received according to order sites and types of prescriptions. And in some cases, more prescriptions can be ordered than those needed actually, so returned-medications will be occurred, and also increased. Then the purposes of these studies are to analyze the states of returned medications in inpatients, and to make strategies to reduced those at SNUH Pharmacy. As the methods of the studies, we made the lists of returned-medications during April 11~15. 2005, and analyzed current conditions and reasons of returned medications. The results of the studies are as follows. The total prescriptions of returned-medications were 2,732 cases which were 5.14% of all prescriptions. There were 15 kinds of reasons to returned-medications. Among them, three reasons were in charge of 67% of all returned-medication, such as 765 cases of canceled prescriptions after dispense, 535 cases of overlapped prescriptions before and after operations and 527 cases of excessive PRN orders, respectively. Except those reasons, there were 196 cases of left medications caused by a daily basis prescription, 174 cases caused by discharges or deaths of inpatients, and 82 cases caused by continuous prescriptions of multiple use drugs, etc. The strategies to decrease returned-medications were established as follows. First, The one more - checking system was applied whether prescription was canceled or not before transferring UDS carts to nurse stations. Second, if prescriptions before and after operations were overlapped, those of post-operation were canceled. Third, in cases of multiple use drugs, we confirmed medical histories of inpatients, and canceled the prescriptions in which the multiple use drugs were continuously prescribed. In order to check the effectiveness of three strategies, we made second studies which were same as first studies during september 5~9, 2005 after introductions of these strategies to dispensing services for inpatients. The total prescriptions of returned-medications were 2,314 cases which were 3.97% of all prescriptions. The 22.8% of cases of returned-medications were decreased after interventions. From the results of these studies, it was noted that three strategies established on the steps of dispense for inpatients were effective to decrease returned-medications.