医療薬学
Online ISSN : 1882-1499
Print ISSN : 1346-342X
ISSN-L : 1346-342X
一般論文
処方入力時の体表面積をベースとした注射薬オーダ上限量警告システム
粟屋 敏雄長谷部 直幸梶野 浩樹石谷 麻里子山田 武宏小野 尚志大滝 康一山下 恭範三好 敏之田崎 嘉一松原 和夫
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2009 年 35 巻 9 号 p. 615-621

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After an overdosing incident at our hospital,we developed an upper limit alert system that checks doses of injection drugs for individual patients as the physician uses the computerized order entry system.Based on each patient’s converted body surface area (BSA),the upper limit for an injection is estimated through comparison with the standard upper limit in a patient with a BSA of 1.6 m2.This is done automatically in accordance with a compensation formula provided by our hospital’s safety committee.Standard upper limits for each injection are based on past records of actual injection dosages administered in our hospital and discussion with clinical departments.When a physician tries to enter an order for an injection at a dose over the upper limit,the computer system issues the alert“non-enterable”and the order cannot be placed.In the case of a regimen for which there is a legitimate reason for using a dose higher than the upper limit,the physician must explain this to the pharmacist who will then unlock the alert system using a secret password that he or she has designated.Passwords are only valid for one day.As far as we know,this is the first computerized injection dosage upper limit alert system in the world.
On doing a search of our database,we found that there had been 742 overdose alerts (0.47% of all injection prescriptions) during the 3 months following its introduction.Owing to the alerts,physicians altered 155 prescriptions (21.1% of all alerts).Our computerized alert system for checking injection dosages has proved to be very necessary in ensuring medication safety.

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© 2009 日本医療薬学会
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