Abstract: Objective To investigate the incidence and causes of irrational medical orders for inpatients from the department of Endocrinology of Liaocheng People’s Hospital.Methods All medical orders written between April 2017 and March 2019 from the Department of Endocrinology in this hospital were previously reviewed by the automatic screening system of prescriptions combined with manual examination. Imperfect medical orders were classified and counted according to types of problems. The Pareto diagram method was used to analyze the primary, secondary and common factors that were responsible for irrational medical orders each quarter. Interventions were formulated according to the results of analysis.Results A total of 795 out of 137,904 medical orders for 4,056 inpatients were problematic, which were of eight types involving solvents, administration frequencies, single dosage, administration time, indications, drug combinations, drug selection and administration routes. By reinforcing rational use of drugs and pharmaceutical care, providing pharmaceutical services, and carrying out multi-departmental interventions, the rate of proper medical orders for inpatients from the Department of Endocrinology increased from 65.19% to over 90%, with a stable index control.Conclusion Pareto diagram analysis can help reduce irrational drug usage clinically, contribute to rational medications, and improve the quality of services rendered by clinical pharmacists.

Key words: review of medical orders, Pareto diagram analysis, rational drug use, clinical pharmacists