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目的:调查西安市医疗机构临床药学工作开展状况,以促进临床药学工作的进一步发展。方法:分级分类抽取西安市24家二级以上医疗机构,对其临床药师现场进行问卷调查,内容包括医院基本信息、临床药师的基本情况、临床药学工作开展状况。结果:被调研医疗机构全职临床药师占60.2%,平均每位临床药师服务床位数为133.1±53.8(床/人)。各医疗机构中主要开展的临床药学工作有用药干预(95.8%)、药学咨询(91.7%)、细菌耐药监测(41.7%)、治疗药物监测(20.8%)。临床药师进行了查房(96.6%)、药品不良反应监测(95.8%)、合理用药培训(84.8%)、患者用药教育(80.5%)、重点患者药学监护(78.0%)、特殊管理药品药学监护(47.5%)、实习生和进修人员培训(61.9%)、疑难危重患者会诊(56.8%)、科研工作(42.4%)等临床药学工作。每天药学服务时间多为1~2 h(68.6%的临床药师)。三级医院、二级医院每日查房频次大于等于一次的分别为34.1%,3.5%。参与会诊的临床药师有67.1%认为“医师会参考临床药师提供的用药信息”。3.4%的临床药师认为“ADR监测工作开展很好且临床很支持”。三级医院临床药师更重视查房、ADR监测和科研工作(P<0.05),二级医院临床药师与护士沟通较多(P<0.05)。结论:西安市各级医疗机构临床药学工作已经普遍开展,但开展情况有差异,三级医院查房频次、ADR监测和科研工作重视程度较高,二级医院与护士沟通较多。
Objective: To investigate the development of clinical pharmacy in medical institutions in Xi’an so as to promote the further development of clinical pharmacy. Methods: Twenty-four medical institutions of secondary level or above in Xi’an were classified by classification, and their clinical pharmacists were surveyed on site, including the basic information of the hospital, the basic situation of clinical pharmacists and the status of clinical pharmacy work. Results: Full-time clinical pharmacists accounted for 60.2% of the investigated medical institutions, and the average number of clinical pharmacists per bed was 133.1 ± 53.8 (bed / person). The main clinical pharmacy work in various medical institutions was drug intervention (95.8%), pharmacy consultation (91.7%), bacterial drug resistance monitoring (41.7%) and therapeutic drug monitoring (20.8%). Clinical pharmacists conducted rounds (96.6%), adverse drug reactions monitoring (95.8%), rational use of drug training (84.8%), patient medication education (80.5%), key patient drug monitoring (78.0%), (47.5%), trainee and fellowship training (61.9%), difficult critically ill patients consultation (56.8%), scientific research work (42.4%) and other clinical pharmacy work. Pharmacy service time per day for 1 ~ 2 h (68.6% of clinical pharmacists). Grade 3 hospitals, secondary hospitals daily rounds of frequency greater than or equal to once were 34.1%, 3.5%. 67.1% of clinical pharmacists participating in the consultation said that “doctors will refer to the information provided by clinical pharmacists ”. 3.4% of the clinical pharmacists believe that “ADR monitoring work well and clinically supportive.” Clinical pharmacists in tertiary hospitals paid more attention to rounds, ADR monitoring and research (P <0.05), and clinical pharmacists and nurses in secondary hospitals had more communication (P <0.05). Conclusion: The clinical pharmacy work of medical institutions at all levels in Xi’an has been carried out universally. However, there are some differences among them. The frequency of rounds of examination in tertiary hospitals, the degree of attention paid to ADR monitoring and research are higher, and there are more communication between secondary hospitals and nurses.