In China, in the 1960s, under the planned economy system, China's drug market system was still not perfect, with a single variety of medical drugs, backward preparation production equipment and a shortage of pharmaceutical professionals. The main task of hospital pharmacy is to ensure the supply of drugs and meet the clinical drug demand. Therefore, although domestic scholars proposed to carry out clinical pharmacy more than 40 years ago, the subjective and objective conditions at that time did not have or allowed to carry out clinical pharmacy work. Until the early 1980s, with the opening and prosperity of the domestic pharmaceutical market, the gradual standardization of drug management, and the establishment of new disciplines such as pharmacokinetics and biopharmaceutics, rational drug use in hospitals finally got the attention of the medical community, and clinical pharmacy really started and developed.
Over the past 20 years, the development of clinical pharmacy in China has made some achievements: (65,438+0) Participating in the design and implementation of clinical drug treatment schemes, assisting clinicians in drug selection and rational drug use, so as to prevent or reduce drug-related damages, improve the level of clinical drug treatment and improve the quality of life of patients.
(2) to carry out pharmaceutical information and consulting services, carry out medication education, publicize and guide patients to use drugs safely.
(3) Carry out clinical pharmaceutical research to provide scientific monitoring or experimental data for improving the level of drug treatment.
(4) Undertake clinical pharmacy education in hospitals, train pharmacists, doctors and community doctors, and carry out medication education for patients. (1) Go deep into clinical departments to understand the trends of drug application and put forward suggestions for improvement;
(2) Attend rounds and consultations, participate in the treatment of critically ill patients and discuss medical records, and make suggestions on drug treatment;
(3) Monitoring therapeutic drugs and designing individualized administration plan;
(4) Instruct nurses to get, keep and use drugs correctly;
(5) Assist clinicians in clinical observation of new drugs after they are marketed, and collect, sort out, analyze and feed back drug safety information;
(six) to provide drug consulting services and publicize the knowledge of rational drug use;
(7) Carry out drug evaluation and drug utilization research in combination with clinical medication. (1) Go to the ward to check the patient first, or learn the general situation of the patient and the latest inspection data through the computer.
(2) to participate in medical rounds, and put forward suggestions on medication in the rounds; Instruct patients to take drugs, inquire and observe the situation after taking drugs, understand the interaction between drugs and food, ensure the safe use of drugs, and record them in the medication calendar written by pharmacists; If an adverse drug reaction is found, enter the adverse reaction handling procedure; Put forward opinions on whether the patient needs to monitor the blood drug concentration after taking the medicine, analyze the monitoring results of the blood drug concentration, and formulate and adjust the administration plan according to the parameters;
(3) guiding the medication of special patients;
(4) Participate in the rescue of critically ill patients and give on-site medication guidance;
(5) Providing drug consultation for doctors, nurses and patients. (1) According to the responsibilities of clinical pharmacists, clinical pharmacists should regularly go to clinical wards to participate in clinical drug treatment rounds, consultations, first aid and case discussions.
(2) Clinical pharmacists should make in-depth clinical rounds not less than 10 times per month, with each time being not less than 2 hours;
(3) Clinical pharmacists' rounds are divided into follow-up rounds and clinical pharmacists' rounds alone. Follow the clinician's rounds, focus on the patient's condition and treatment difficulties, and participate in the medical group discussion at the end of rounds. Clinical pharmacists' separate rounds are mainly aimed at key patients under special circumstances (such as adverse drug reactions, critically ill patients, patients with complicated drug treatment and severe damage to liver and kidney functions, etc.). ). Clinical pharmacists can ask patients or accompanying personnel after consulting medical records and communicating with doctors to understand the condition. Make at least/kloc-0 rounds in a single pharmacy every week, establish a medication calendar for key patients, and make work records;
(4) Participate in the rescue of critically ill patients and discuss medical records, and make records. Before attending the consultation, clinical pharmacists should consult medical records, ask questions in advance, understand the condition, consult and calculate the necessary data, and put forward scientific and cautious opinions to help clinicians improve the treatment effect. Clinical pharmacists should actively participate in and participate in other related consultations in their clinical departments;
(5) Make work summary every week, hold 1 work meeting every month, exchange experiences, communicate information and discuss difficult medical calendars;
(6) Clinical pharmacists should actively consult pharmaceutical information and give positive answers to questions raised by doctors, nurses and patients. If you can't give an answer at that time, you should record it in time, consult relevant experts or consult relevant materials afterwards, and try your best to give a satisfactory answer. Key consultation or typical problems should be recorded in detail and summarized at the end of the year;
(7) Collect, sort out, analyze and feed back drug safety information, do a good job in monitoring adverse drug reactions, actively care for and guide patients with adverse reactions, and help them improve drug compliance. Do not miss serious adverse drug reactions, and publish 1 drug news every quarter;
(8) Assist medical staff in designing, applying, sampling, interpreting and adjusting medication according to clinical needs and drug characteristics, actively record patients' condition and monitoring results, and accumulate population pharmacokinetic data.
(9) In combination with clinical medication, actively carry out drug evaluation and drug utilization research such as medical records and prescription analysis, establish 1 key drug utilization research topics every year, and write research and analysis reports; Actively communicate with medical staff in many aspects, find out the urgent clinical pharmaceutical research topics, and promote the development of clinical pharmaceutical research; Hold pharmaceutical education lectures at least once a year, with lecture notes and published papers 1 more; However, according to this method, the clinical pharmacist 1 assessment is organized every year, and the assessment results are recorded in the year-end assessment results.