CAJ | 학술논문

目的研究不同级别医院药师对处方点评标准的个体间差异,分析在药事服务中点评标准的稳定性. 方法将来自不同级别医院、不同岗位的甲、乙、丙、丁4位药师分别对552 张相同处方进行点评,判断处方是否合理以及对判定为不合理处方进行归类. 利用Kappa一致性检验来评价不同药师间点评结果的一致性.结果丙药师与丁药师的点评结果一致性最强,Kappa值为0.843 0,差异无统计学意义(0.1<P<0.25);其次是甲药师与丁药师,Kappa值为0.803 8,差异有统计学意义(0.01<P<0.025);乙药师与丙药师点评结果的一致性相对最差,Kappa值为0.624 0,差异有统计学意义(0.01<P<0.025). 结论不同级别医院药师对处方点评结果的差异较大,不一致性的根本原因在于点评标准的个体间差异,包括药师个人主观的理解认知以及医院客观的限制条件.
목적 연구불동급별의원약사대처방점평표준적개체간차이,분석재약사복무중점평표준적은정성. 방법 장래자불동급별의원、불동강위적갑、을、병、정4위약사분별대552 장상동처방진행점평,판단처방시부합리이급대판정위불합리처방진행귀류. 이용Kappa일치성검험래평개불동약사간점평결과적일치성.결과 병약사여정약사적점평결과일치성최강,Kappa치위0.843 0,차이무통계학의의(0.1<P<0.25);기차시갑약사여정약사,Kappa치위0.803 8,차이유통계학의의(0.01<P<0.025);을약사여병약사점평결과적일치성상대최차,Kappa치위0.624 0,차이유통계학의의(0.01<P<0.025). 결론 불동급별의원약사대처방점평결과적차이교대,불일치성적근본원인재우점평표준적개체간차이,포괄약사개인주관적리해인지이급의원객관적한제조건.
Objective To study the individual difference of prescription comment standard from different lev-els of hospital pharmacists, and analyze the stability of the prescription comment standard in pharmacy prac-tice. Methods Four pharmacists from different levels of hospitals made comments on 552 prescriptions respectively, and the rationality of prescription was determined. The consistency of different pharmacists′comments was evaluated by Kappa consistency test. Results The comments consistency of pharmacist C and pharmacist D was strongest,Kappa value was 0.843 0,with no significant difference (0.1<P<0.25);the Kappa value of pharmacist A and pharmacist D was 0.803 8,there was significant difference (0.01<P<0.025);the comments consistency of pharmacist B and phar-macist C was the worst,the Kappa value was 0.624 0,there was significant difference (0.01<P<0.025). Conclusion The prescription comment results by pharmacists from different hospitals have obvious differences,the root cause of the inconsistency is the differences between individuals comment standard,including pharmacist′s personal subjective understanding of the cognitive and objective conditions of hospital.