临床药师在普外科开展药学服务的实例分享及体会

摘 要 目的：总结临床药师在普外科开展药学服务的经验, 探索药师参与临床药物治疗实践模式。方法: 从药物重整、药物不良反应的发现及处置、药物治疗方案的参与制定三方面分享临床药师在普外科参与药物治疗的典型实例并进行分析。结果: 临床药师通过药物重整提高了患者用药的准确性和有效性，通过及时发现肝素引起的血小板减少症并停药避免了患者发生出血不良事件的风险，参与制定抗感染方案使得患者切口感染得到迅速而有效的控制。结论:临床药师深入病区开展“以患者为中心”的药学服务，提高了患者用药安全性及合理性，对提高临床医疗质量具有重要的作用。

Case Sharing and Experience of Pharmacy Service Performed by Clinical Pharmacist in General Surgical Department

ABSTRACT Objective: To summarize the experience of pharmacy service performed by clinical pharmacist in general surgical department and explode the practice mode of clinical pharmacist participating in clinical drug therapy. Methods: The typical cases participated by clinical pharmacist in general surgical department were shared and analyzed from three aspects of medication reconciliation, the detection and disposal of adverse drug reactions and formulation of therapeutic regimen. Results:Clinical pharmacist increased the accuracy and effectiveness of drug therapy through medication reconciliation, avoided the risk of bleeding events through timely identifying heparin induced thrombocytopenia, and controlled the incision infection quickly and effectively through the participation in making anti infective regimen. Conclusion:Clinical pharmacist should perform patient centered pharmacy service in ward, which can enhance the safety and rationality of drug use in patients and play an important role in promoting health care quality.