Pharmaceutical care is a field of hospital pharmacy at home and abroad in recent years.
Hot topic. It is an important link in the implementation of medical prevention and treatment in hospitals, and it is also the working mode of pharmacy department in 2 1 century.
An important aspect of reform. Modern hospital pharmacy will change from drug supply management to pharmaceutical service. Suishe
With the development of society and the renewal of ideas, health needs pharmaceutical services, which is also the way out for traditional pharmacists in China.
In the past, pharmacists had little contact with patients, and the task of pharmacists was to adjust and supply drugs. Hospital drugstore
With the development of medicine, especially the rise of clinical pharmacy, this situation is also undergoing fundamental changes. Development of hospital pharmacy
The exhibition has gone through three periods: ① the traditional adjustment period; ② Clinical medicine semester of pharmaceutical service.
③ The stage of pharmaceutical care aimed at improving patients' quality of life. The three main contents of pharmaceutical care are: drugs.
Teachers participate in clinical, therapeutic drug monitoring and drug information consultation. Pharmacists' participation in clinical practice will make pharmacists directly related to diseases.
People establish contacts and directly participate in the formulation of drug treatment programs, which is a fundamental change in the functions of pharmacists.
Flavoring pharmacists should bear the responsibility of drug monitoring in the whole process of patient treatment.
Drug therapy can relieve pain and bring happiness to many patients, but it can also cause many man-made drug injuries.
Cause sequelae and even death. In fact, most problems are not drugs themselves, but prescription, dispensing or administration.
Caused by improper medication. Therefore, pharmacists have the moral responsibility to protect patients from drug harm.
With the change of people's health concept, the requirements for the quality of treatment and quality of life are constantly improving, and they are no longer satisfied.
There are enough drugs, but high-quality, safe, reasonable and economical services are needed, so pharmaceutical services have emerged.
Life has become an inevitable trend. [ 1]
1, the definition of pharmaceutical service Pharmaceutical service is the process of communication between pharmacists, patients and other professionals.
Staff cooperate to design a treatment plan, and its implementation and monitoring will produce special therapeutic effects for patients. It includes
Three major functions ① Finding potential or actual medication problems ② Solving actual medication problems ③ Prevention.
Eliminate potential medication problems.
The unified definition of pharmaceutical services is: "The mission of pharmacists is to provide pharmaceutical services. Pharmaceutical services are aimed at providing
Direct and responsible drug-related monitoring aims to improve the quality of life of patients "[2]. A pharmacist's job
Facing patients directly, we must assume the social responsibility of supervising, executing and ensuring patients' safe and effective medication.
In order to improve the physical and mental health of patients to the greatest extent.
2, the main content of pharmaceutical care
2, 1, organically combine medical treatment, pharmacy and nursing, so that doctors, pharmacists and nurses can cooperate with each other.
Force, * * * have medical responsibility.
2, 2, not only for patients, but also for the national health education of the whole society.
2, 3, guide and help patients and medical staff to use drugs safely, effectively and reasonably.
2, 4, regular scientific evaluation of drug use and management.
It can be seen that the working mode of hospital pharmacists will change. They are not just preparing drugs, but
Together with doctors and nurses, directly face patients, participate in treatment, guide medication, and work in the clinical front line.
3. The responsibilities and tasks of pharmacists in pharmaceutical care
3, 1, together with the doctor to decide whether the patient needs medication, clear treatment objectives, for this reason.
Objective to design a drug treatment plan, monitor the whole process of drug use, make a comprehensive evaluation of drug treatment and find that
And report the allergic reactions and side effects of drugs to minimize adverse drug reactions and harmful drug interactions.
The appearance of functions.
3, 2, comprehensive management of all resources needed for pharmaceutical services, including personnel and drugs.
3, 3, to ensure the rational use of drugs, that is, safe, effective and economical use of drugs, according to the patient's disease type, nature, onset time, past medication history, whether there is drug allergy, etc. Choose safe, effective and appropriate drugs.
Dosage form, administration route and administration method of Dang.
The specific task of pharmacists in providing pharmaceutical services is to find, prevent and solve problems related to medication. For example, ①
The drug is correct; ② Appropriate indications for medication; ③ Safe curative effect and reasonable price; ④ Dosage, usage and course of treatment
Appropriate (determine the dosage and course of treatment according to the knowledge of pharmacokinetics and pharmacodynamics); (5) the drug object is appropriate (no contraindications,
Adverse reactions are small); ⑥ correct deployment; ⑦ Patients have good compliance. [3]
4. The position of hospital pharmacists in pharmaceutical care.
4. 1, the customer of pharmacists is patients.
As the client of patients, pharmacists must establish a "one-to-one" business relationship with patients.
4.2. Establish a new partnership of "prescribers, pharmacists and patients"
Pharmaceutical service requires breaking the division of labor within pharmacies, such as "pharmacy pharmacists" and "preparation pharmacists". Request office
Some pharmacists assume the responsibility of patient care, and think that all the staff in the pharmaceutical department are the providers of patient care.
Who? Other medical staff and patients can have a direct conversation in Yamatonokusushi, which can play an extended role as a doctor and become a cure.
Members of the treatment team. [4]
5. The importance of pharmaceutical care
First, promote rational drug use and improve the therapeutic effect of drugs. Secondly, it reduces the number of drugs.
Adverse drug reactions can prevent some drug-induced diseases. Third, the patient's disease can be cured.
Eliminating or alleviating symptoms can achieve the fundamental purpose of improving the quality of life of patients and prolonging their lives. Fourth, by
In order to greatly reduce or eliminate irrational drug use, save drug resources, and thus reduce medical expenses, firstly,
Fifth, the status and image of pharmacists have been improved, and their income has also increased.
Clinical pharmacy started late in China, but pharmaceutical care is in the publicity period. But,
Irrational drug use is widespread in China, and the unqualified prescriptions in some primary hospitals are as high as 60%. Question 10.
Seriously. Pharmaceutical service is the inevitable trend of hospital pharmacy development in 2 1 century.
6. Obstacles to the implementation of pharmaceutical care in China [3, 4, 5]
6, 1, conceptual barriers
6. 1, 1 Go beyond the traditional work of pharmacists and realize the transition from "ensuring the quality and supply of drugs" to.
It is difficult for pharmacists to adapt to the great change of "being responsible for patients' medication results", especially the current drug treatment decision.
It was made by the doctor, and the pharmacist was not responsible. Implement pharmaceutical care, authorize pharmacists to participate in drug decision-making,
Responsible for monitoring the medication process, observing the patient's drug reaction and making necessary adjustments, and tracking the final conclusion of medication.
Fruit, make the necessary evaluation.
6, 1, 2, Beyond the concept of treatment, the service provided by PC is not only to treat patients.
Both diseases should be cured and patients' health should be restored, so that patients can maintain good physical function and mental state.
State, health and happy life.
6, 1, 3, the concept of evaluating treatment results beyond biological indicators now evaluates drug treatment results.
These indicators are just some observed data. For example, when anticancer drugs are used for cancer patients, the patient's life expectancy is
How many years to extend is an index to evaluate the quality of treatment. However, behind the pharmacological effects of anticancer drugs, diseases
Did not take into account the serious side effects of drugs (deterioration of quality of life) on people. launch
When PC is working, it is necessary to comprehensively evaluate the influence of drugs on patients' overall function and quality of life.
6, 1, 4, which goes beyond the narrow geographical concept of specific medical institutions.
6, 1, 5, beyond the current division of pharmaceutical business, all pharmaceutical staff in the hospital, although the division of labor is different,
But the overall goal is the same, that is, to provide patients with services to improve their quality of life through drugs and pharmaceutical means.
6, 2, drug resource barriers
6, 2, 1, time is insufficient. At present, pharmacists in China have to spend a lot of time on routine drug supply, that is to say,
Even pharmacy pharmacists who have the most contact with clinic can hardly concentrate on rounds, attending meetings and consulting doctors.
Calendar, drug consultation, drug monitoring, adjustment suggestions, etc. Besides, pharmacists don't have enough time.
Ensure that all patients read the medical records within 24 hours after taking the medicine and find out the problems in the medicine in time.
6, 2, 2, personnel restrictions Most of the pharmaceutical personnel in hospitals in China are on the low side, and the personnel structure is complex.
Coupled with the relative lack of clinical knowledge of pharmaceutical personnel, it is impossible to carry out time-consuming and laborious pharmaceutical monitoring work.
6, 2, 3 Limited workplace and technical conditions At present, the hospital infrastructure in China has been greatly improved.
However, it is not yet possible to set up a workplace for PC pharmacists in every clinical department. In addition, the current hospital
The economic situation generally introduces expensive new technologies and equipment unconditionally.
6, 3, obstacles in the medical system
The existing medical system has a high degree of division of labor, and the consistency of pharmaceutical services requires the medical system to be a complete body.
Departments must change this division of labor.
6.4. Information resource barriers
6, 4, 1, pharmacists who lack medical information to provide pharmaceutical services should not only be able to obtain drugs in time.
Knowledge and the latest information, and more importantly, be able to obtain the patient's medical documents (past medical history, course records)
Records, etc. ), but pharmacists often don't get this information easily, so it is necessary to solve the problem of * * * enjoying medical information.
6, 4, 2, pharmacists lack experience in writing medical documents, and their professional knowledge focuses on drugs.
Research, lack of clinical experience and skills.
6, 5, regulatory barriers
The traditional task of hospital pharmacists is mainly to purchase and supply drugs and distribute them to the recipients. Pharmacists can only be permitted by laws and regulations.
Conditions, to carry out business activities within the scope of its functions and powers. To carry out pharmaceutical care business, it is necessary to formulate the Pharmacist Law and
Add corresponding clauses in relevant laws and regulations.
7. Pharmaceutical care is imperative [1, 3]
Although pharmaceutical service is still in the stage of publicity and introduction, it is very difficult to implement, but pharmaceutical service has given drugs.
Academics and hospital pharmacists are generally concerned. Reasons ① The objective conditions for the development of pharmaceutical care have been gradually formed.
With the improvement of people's living standards, people's demand for medical care, especially drug treatment, has increased to improve the quality of treatment.
Even a high-quality life, therefore, the objective conditions for carrying out this work have gradually formed; ② Traditional hospital supply
With the transformation of medical model and the scale and high-quality development of pharmaceutical industry, hospital preparations will gradually decrease and shrink; medicine
The modern management of departments has fundamentally changed the traditional drug supply mode of hospitals; (3) Using computers, the pharmacy is overstaffed.
Therefore, if we don't think about reform and progress and stand still, the fate of "being laid off" will fall on traditional pharmacists.
On the head, people need pharmaceutical services, and pharmaceutical services are also the next step for hospital pharmacists. we should
Starting from renewing our own ideas, we should correctly publicize pharmaceutical services, understand pharmaceutical services and consciously strengthen ourselves.
Learn and adapt to pharmaceutical services, clear all kinds of obstacles on the way forward for the implementation of pharmaceutical services in China, and work hard.
Create an environment in which pharmaceutical services are gradually rooted in the hearts of the people and develop healthily.
Future hospital pharmacists should know both medicine and clinic, and their basic work includes: monitoring blood drug concentration.
And explanation, clinical treatment consultation and consultation, single dose operation, drug education after discharge, outpatient diseases
Drug consultation, monitoring and identification of adverse drug reactions, development of new scientific preparations, and participation in clinical evaluation of new drugs.
Planning, etc. Giving full play to the professional expertise of pharmacists can ensure the ideal drug use effect and reduce the risk of drug abuse.
Collect medical expenses. As far as possible, every patient can maintain normal physical function after receiving drug treatment.
Live a healthy and happy life. [6]
refer to
A new stage of the development of advanced pharmacy —— China Journal of Pharmacy,1995,30 (2): 97.
Zhang Xinping, Guo Haiping, Journal of Pharmaceutical Care and Clinic of Yang Zhimin China Hospital, 1996, 16 (10): 469.
Chen Qiuchao's pharmaceutical service is an important part of clinical pharmacy. China Hospital Pharmacy Journal, 1996, 16 (9): 393.
Tang Jingbo's integrated supervision and guidance of drug supply and use in China Pharmacy,1998,9 (5):198-201.
Hu Jinhong, Cai Qin Pharmaceutical Service China Pharmacy,1998,9 (6): 283-285.
Zhang Junwei Hospital Journal of Pharmaceutical Work Mode and Pharmaceutical Health Care Practice 1995,13 (2):114-18 Source: www.lw3721.