临床药师参及内分泌科全医嘱审核结果分析.docVIP

临床药师参及内分泌科全医嘱审核结果分析 　　[摘要] 目的 分析临床药师通过对其所在病区医嘱进行点评并及时干预的实践，以促进临床合理用药。方法 临床药师对2015年参与的上海交通大学附属第一人民医院（松江南院）内分泌科全医嘱审核结果进行分析，总结不合理用药情况。结果 内分泌科不合理用药医嘱共240条，常见不合理问题为药物使用时间不适宜、药物遴选不适宜、联合用药不适宜、药物使用方法不适宜等；不合理用药医嘱主要涉及内分泌科、心内科、消化科等科室用药；经过临床药师与病区医生沟通，对每月不合理医嘱进行干预，内分泌科2015年不合理医嘱占比呈季度下降趋势。结论 通过全医嘱审核方式，临床药师在提升自身业务水平的同时，也保证了患者用药安全合理，充分体现其作为治疗团队中的一员的价值所在 [关键词] 全医嘱审核；不合理医嘱；实时干预；临床药师 [中图分类号] R952 [文献标识码] A [文章编号] 1673-7210（2017）04（b）-0136-04 [Abstract] Objective To promote rational drug use in the clinic through examing prescriptions and rectifying irrational medications immediately in the ward by clinical pharmacist. Methods The results of the whole medical advice were reviewed and analyzed by clinical pharmacists during 2015 in Department of Endocrinology， the First People′s Hospital， Shanghai Jiaotong University. Results Among the 240 irrational medications in endocrinology department， the common problems were inappropriate medication time， inappropriate drug， inappropriate drug combination and inappropriate drug use method. The irrational drug use mainly involved endocrinology department， cardiology department and digestive department， etc. The amount of irrational medicatons during 2015 in endocrinology department declined quarterly through communicating with ward doctor and rectifying irrational medications immediately by clinical pharmacist each month. Conclusion Clinical pharmacist participates in the medical orders review， which fully reflects their value as a member of treatment team， not only enhancing the professional quality themselves， but also ensuring the rational，？safe？drug use for patients. [Key words] Whole medical advice review； Irrational order； Real-time intervention； Clinical pharmacist 早在20世纪50年代，美国就开始设置药学博士（Pharm D）学位，专门培养为患者或专业卫生人员提供药物治疗方面相关信息的药物治疗专家或临床药学专家[1]。在?W美的一些国家，临床药师充分参与患者的临床治疗工作，成为医师选药和用药的重要参谋，在临床合理用药中起到举足轻重的作用 按照2002年颁布的《医疗机构药事管理暂行规定》[2]的要求，医院药学工作要逐步转型，从以保障供应为中心转变为以患者为中心；从以药品调配、药物制剂工作为主体转变为以临床药学工作为主体；建立“临床药师制”，开展以患者为中心的临床药学工作。21世纪的医院