Validation of a Survey Instrument to Evaluate Students' Learning During Community-based Advanced Pharmacy Practice Experiences

Objective

To develop and validate a preceptor/student self-report survey instrument to distinguish between different advanced pharmacy practice experience (APPE) models based on pharmaceutical care competencies.

Methods

The survey instrument''s psychometric properties and differential impacts of 3 community-based APPE models were evaluated retrospectively.

Results

Five dimensions characterized APPE learning: importance of 14 pharmaceutical care competencies; agreement with pharmaceutical care procedures in practice; gains in perceived pharmaceutical care abilities; and learning climate and preceptor support. Most of the survey instrument scales detected student/preceptor differences as well as differences in APPE model structures. A streamlined, 30-item short form was validated against the full 78-item survey instrument.

Conclusions

This study confirms that APPE learning can be quantified to: (1) identify high-risk students, (2) train new or continuing preceptors, (3) promote skills-training for select pharmaceutical care competencies, (4) add clarity and structure to APPE learning objectives, and (5) provide students and preceptors with common frameworks for negotiating the APPE experience.     

门诊药房开展全面药学服务的做法和体会

目的探讨门诊药房药学服务模式,提高患者用药依从性,促进合理用药。方法通过提供用药指导、药物咨询、ADR收集与报告、合理用药宣传等方式进行药学服务。结果药师发挥了应有的作用,提高了患者的满意度,药物得到有效应用。结论药师积极开展药学服务,对确保药物疗效、降低不良反应发生率、减少不合理用药等方面起着重要的作用。     

浅谈住院药房药师如何为临床开展药学服务

目的:促进用药安全、有效。方法:住院药房药师根据临床具体需求,从细节入手,包括为临床整理常用化疗药物的说明书,为糖尿病患者提供面对面的用药指导,制作口服药物识别的小册子,帮助病区管理小药柜,确保与临床沟通渠道通畅等。结果与结论:住院药师应开展临床实际需要的药学服务。     

超越pharmaceutical care，呼吸中国特色的药学实践规范

本文将各种药学实践模式及中国药学实践规范加以阐述。药学实践在美国可分为5个阶段,Pharmaceutical care（PC）是美国药学发展的一个新阶段,此概念已进入国内药学。虽然国外药学已走上规范化发展,但国内药学存在许多问题,药学工作离规范化发展相距甚远,因而建立中国药学实践规范极有必要。为此,我们提出了中国药学实践规范的初步建议。     

Pharmaceutical Care Plan Examinations to Identify Students at Risk for Poor Performance in Advanced Pharmacy Practice Experiences

Objectives

To evaluate early predictors of advanced pharmacy practice experience (APPE) performance using either timed pharmaceutical care plan (TPCP) reports of 4 case histories or traditional lecture-based pharmacotherapy course examinations.

Methods

Statistical process control (SPC) methods were used to identify a group of third-year pharmacy students “at risk” for poor APPE performance (defined as an APPE grade point average of < 3.0). Examination scores from an integrated lecture-based pharmacotherapy sequence were used for comparison.

Results

TPCP scores but not lecture-based examination scores successfully identified 6 of 10 students who ultimately performed poorly in their APPEs.

Conclusion

Adaptation of SPC methods to assess student performance during problem-based learning (PBL) case reports is a useful technique for identifying students “at risk” for poor APPE performance.     

药学监护实践——21世纪中国药师面临的机遇和挑战

目的迎接21世纪,促进中国医院药学实践水平的提高,推动医院药学学科向前发展.方法 总结近年来国外介绍药学监护的有关文献,了解药学监护在理论和实践方面的进展,提出我国实施药学监护的策略.结果 药学监护的概念在不断完善,药学监护实践的内容更加具体.本文概述了药学监护实践的学科基础,基本要素及具体实施的过程,提出了面向21世纪,我国实施药学监护的战略.结论 药学监护是医院药学实践的崭新内容,中国药师应加强学习,迎接挑战.     

School-wide Clinical Intervention System to Document Pharmacy Students' Impact on Patient Care

Objectives

To implement and evaluate a school wide, Web-based clinical intervention system to document types and impact of pharmacy students'' clinical activities during advanced pharmacy practice experiences (APPEs).

Methods

A clinical intervention form was developed by pharmacy practice faculty consensus and uploaded to a secure Web site. Prior to APPEs, all pharmacy students were trained on the purpose and use of the system as well as strategies to document interventions appropriately.

Results

Over the 3-year period of data collection, 15,393 interventions were documented. Most common intervention types included dosage adjustments, education of patients and providers, and optimization of therapeutic regimens. The majority of the interventions were accepted by the medical team and resulted in positive clinical and economic outcomes.

Conclusions

Our school-wide system allowed students and faculty members to document clinical activities. Reporting can serve a number of purposes, including incorporation into student portfolios and faculty merit and promotion dossiers, and demonstration of the positive impact on patient care.     

药学信息服务在医院药房中的应用

目的:探讨中药信息服务在综合性医院中药房中的应用。方法:利用药学信息服务平台和HIS系统建立中药饮片的全方位信息化服务子平台。结果:提升了中药饮片合理用药水平,拓展了中药药学服务。结论:药学信息化服务水平在中药房得到了提高,促进了医院中药房药学服务的发展。     

实践《用药交待规范》提升药学服务满意度

目的 宣贯《用药交待规范》，运用多种举措优化药学服务，提升医院门诊药房患者满意度。方法 通过开展基于三维多级工作模式的用药交待服务，随机选取2019年11月—2020年12月共400例门诊药房取药患者，以现场问卷及电话回访等方式收集患者对药学服务的满意情况，并根据数据分析结果总结项目成效和改善价值。结果 用药交待新模式实施前后共取得患者有效反馈记录196份和197份，实施用药交待服务后，“药师专业水平”(78.06%至90.36%)、“用药交待形式”(77.55%至88.83%)、“服务礼仪”(78.57%至87.82%)等指标的患者满意度均有显著提升。结论 开展层次化、标准化、多元化的用药交待服务，有利于提升门诊药房患者满意度。     

Web-based Portfolios for Pharmaceutical Care Plans During Advanced Pharmacy Practice Experiences

Objective

To implement and assess a Web-based patient care portfolio system for development of pharmaceutical care plans by students completing advanced pharmacy practice experiences (APPEs) throughout a statewide preceptor network.

Design

Using a Web database, students in APPEs documented 6 patient cases within 5 disease state categories. Through discussion of the disease states and inclusion of patient information such as problems, desired outcomes, and interventions, a complete pharmaceutical care plan was developed for each patient.

Assessment

Student interventions were compared by geographical regions to assess continuity of patient care activities by students. Additionally, students completed an evaluation of the portfolio course to provide feedback on the portfolio process. Students documented an average of 1.8 therapeutic interventions per patient case and documented interventions in all geographical regions. The majority of students indicated that the portfolio process improved their ability to develop a pharmaceutical care plan.

Conclusion

The Web-based patient care portfolio process assisted with documentation of compliance with Accreditation Council of Pharmacy Education (ACPE) standards and College of Pharmacy Competency Statements. Students indicated the portfolio process was beneficial in developing skills needed for creating pharmaceutical care plans.     

利用流程再造优化门诊药房服务

目的:利用业务流程再造优化门诊药房工作流程,为患者提供更好的服务。方法:依据门诊药房工作特点,分析旧流程中存在的问题,通过合并、调整、优化,设计并实施新流程。结果:实施新流程后,发药区与调配区完全隔断,采取自助刷卡缴费、取号排队,使患者排队时间明显缩短、取药环境得到改善、用药安全获得保证。结论:新流程的实施提高了药学服务质量。     

我院儿科药房药学服务SWOT分析及改进

目的提升医院儿科药房药学服务的质量。方法采用SWOT分析法从优势、劣势、机遇、威胁4个方面分析医院儿科药房药学服务的开展情况,并提出有针对性的发展策略。结果医院全面落实用药交代,加强合理用药宣传,普及用药知识,开展药物治疗监测及药物基因检测等,实现了个体化精准用药;增加处方前置审核,运用信息化技术,可为患儿安全用药保驾护航。结论建议医院应加强对儿科药学服务的重视,建立更完善的儿科药学服务体系;药师应明确自身定位,发扬优势,弥补劣势,积极探索多元的药学服务模式,以促进儿童安全、合理用药。     

药学监护的发展与策略

鉴于药源性灾害的严重性日益被人们认识，药学信息日益丰富，药品工业的社会化大生产使药房调剂工作与内部制剂生产衰落，加上对医院通过药品销售获利的限制日趋严格，导致临床药学的兴起并使医院药学工作者责无旁贷地要肩负保障病人用药安全有效，确保药疗有益病人心身健康的社会责任。美国医院药师学会在１９９２年提出把这种责任──药学监护作为医院药房工作质量标准，要求医院药房进行以药学监护工作为中心的组织机构与业务实践改革。药学监护作为跨世纪药房工作的特征，值得我国药学工作者给予足够的重视。本文就药学监护的含义、起因、内容作了论述。并结合国情与作者经验介绍了我国推行药学监护的障碍与克服困难的策略提出了以搞好合理用药，完善临床药理／临床药学服务作为开始ＰＭＣ初级阶段的建议。     

药学监护及其在中医医院开展之我见

继临床药学之后出现的另一概念———药学监护明确了药师与患者的直接关系。本文介绍药学监护的概念、内容及发达国家药学监护工作的开展情况，并对中医医院的药学监护工作提出建议     

临床药师开展药学监护工作方法之我见

目的 :探讨临床药师在药学监护工作中应注意的问题。方法 :概述并分析了合理用药和药学监护工作的现状及存在的问题。结果与结论 :临床药师已成为临床治疗中的重要角色 ,掌握必要的医学知识 ,在合理用药方面同医师相互沟通并掌握丰富的药学知识是药学监护的必要条件。     

我院药剂科建立药学服务网站方法初探

目的：建立药学服务网站,实现药学信息服务全程化、网络化,扩大医院药师的药学服务范围。方法：利用计算机网络技术和数据库技术,整合各类药学信息并进行再处理,实现对内、对外药学信息服务的相关应用和及时维护。结果：网站运行稳定,维护方便,可提供多种药学服务。结论：药剂科药学服务网站的建立为患者、药师以及医务工作者提供了一个方便、高效的交流平台,对实现全程化药学服务起到了推进作用。     

药学诊断在临床药学实践中的应用

目的:探索适合我国临床药学工作开展的模式。方法:阐述药学诊断的定义及主要内容,结合开展临床药学的经验,将药学诊断的主要内容设计成"药学诊断临床应用表",并进行实践。结果与结论:"药学诊断临床应用表"可在临床实践中帮助临床药师理清思路,发现药物应用相关性问题,提高工作技能和药学服务质量。     

儿童糖尿病的药学监护

探讨儿童糖尿病的药学监护模式。对我院16例糖尿病儿童的药学监护工作进行总结分析。临床药师深入临床,参与儿童糖尿病临床用药决策,开展药物咨询,进行药物经济学评价。使我院糖尿病儿童享受全程药学服务。结果表明,科学的药学监护是保证儿童糖尿病治疗有效和提高生活质量的关键之一。     

从实例中体会临床药学服务

目的:探讨临床药学服务的内容和作用。方法:通过实例,对我院开展临床药学服务的经验进行总结。结果与结论:临床药学服务有利于医院提高医疗质量、减少医疗风险。医院应建立临床药师制,支持临床药师工作。     

药学监护的实施

医药科技的飞速发展与药师保障病人用药安全、有效、经济，造福病人身心健康的社会责任，推动了医院药学的改革。８０年代中期提出的药学监护，使医院药学实践迈向了新的高度，美国医院药师学会在１９９２年提出了把药学监护作为药房工作质量标准，要求药房进行以药学监护为中心的组织机构与业务实践改革。药学监护作为跨世纪发达国家药房工作的中心，应受到我国药学工作者的高度重视。本文就药学监护的实施方案与我们的思考与对策作简要论述。