我院门诊药房窗口服务中存在的问题及分析

目的:查找目前工作中存在的问题,进行针对性改进,以提高服务质量。方法:向患者随机发放调查问卷,请患者参与评定,提出意见。对2008-2009年患者提出异议的事件进行总结和分析。结果:患者对我院门诊药房窗口服务满意度较高,但仍存在需要及时解决的问题。结论:门诊药房应优化取药流程,树立"以患者为中心"的服务理念,加强对药学人员的专业素质和个人素质的培养,进一步提高药房窗口的服务质量。     

Evaluating outpatient pharmacy services: a literature review of specialist heart failure services

Objective To identify appropriate methods to evaluate a specialist pharmacy service for heart failure patients in an ambulatory care setting. Method An extensive literature review was undertaken to identify the published data on evaluative studies of specialist pharmacy services, including those directed at heart failure patients in an ambulatory care model of service provision. Key findings Six studies were identified evaluating outpatient pharmacy services for heart failure. The pharmacy services provided in these settings were not well defined. The impact of the pharmacist was compared to ‘usual care’, that is care delivered without a pharmacist, by either a prospective randomised controlled trial (RCT), or before and after studies. In most cases the service was delivered by one pharmacist at one site. Services were primarily targeted at patients and focused on medication and lifestyle education, adverse drug reaction monitoring, and compliance/adherence. In all studies, there was a trend for improvement in the outcomes measured. Different study endpoints were examined, including process indicators such as compliance and outcome measures such as morbidity (clinical), quality of life (humanistic), and hospital admissions (economic). The ideal evaluative study would be an adequately powered, prospective, randomised controlled trial, comparing the effect of the pharmacist service to usual care (without the specified pharmacy service). Appropriate study endpoints including process indicators and outcome measures are needed. Identification of specific components and the extent of the service that would provide the most benefit to selected patient groups would be of interest. Conclusions Specialist ambulatory care pharmacy services have not been well defined or evaluated in the literature. Limited randomised controlled data exist.     

门诊小儿呼吸道感染患者的药学服务分析

目的:分析门诊小儿呼吸道感染患者的药学服务.方法:资料选取我院2013年1月～2015年12月收治的160例门诊呼吸道感染患儿予以回顾性分析,观察并对比药物使用情况、抗菌药用药频度及药物利用指数.结果:本组患儿药物使用率为94.38％(151/160),显著高于卫生部规定的药品使用率控制在60％以下标准;本组患儿采用的抗菌药物共25种,主要为头孢菌素类与青霉素类;联合应用抗菌药物需存在明确指征,单一使用药物可治疗感染无需联合用药,联合用药需至少予以联合2种药物,≥3种药物联合只适用个别情况,本组患儿抗生素应用主要为单联与二联用药;小儿无专门药理代谢实验,通常药物使用剂量参照成年人使用,并根据体质量确定药物使用剂量;DDDs排序列前10位药物及DUI值.结论:门诊小儿呼吸道感染行抗菌药物治疗率较高,医院应加强小儿呼吸道感染使用抗菌药物的规范管理,最大限度提高治疗效果.     

南京市第二医院门诊药房开展用药咨询服务的现状与体会

随着医疗改革的不断深入,药学服务(pharmaceuticalcare)的概念已被越来越多的药学人员接受并重视。用药咨询是药学服务的一种方式。如今,医疗机构药学人员的职责已发生了较大的变化,由以前的制剂生产和处方调配为主,转向为病人提供包括药物临床应用在内的全程化服务,其目的是使病人得到安全、有效、经济、合理的治疗药物,达到身心全面康复的目的,实现人类生活质量的改善和提高。本文对南京市第二医院门诊药房开展用药咨询服务的情况进行调查分析,并就工作中取得的经验和体会与同仁交流。1资料和方法本院每周一至周五上午由门诊药房主管药师以上职称的药师轮流,以柜台式当面咨询为主、电话咨询为辅的形式开展用药咨询     

浅析门诊西药房退药

目的探讨退药原因,减少或规范退药。方法通过人工收集某院干预前2011年7～12月退药处方388份和干预后2012年1～6月退药处方134份找出退药原因,提出应对措施。结果退药由医师、患者、药房、其他等多方面原因引起,其中医师方面是引起退药的主要原因,由干预前169例（构成比43.56%）下降到干预后31例（构成比23.13%）;其他方面药物不良反应为主要影响因素,由干预前的135例（构成比34.79%）下降到干预后的20例（构成比14.93%）。退药科室主要集中在急诊科。结论退药现象客观存在,应加强以患者为中心的服务意识,完善各项规章制度,减少退药。     

仿效临床医师的诊疗方式,在门诊大厅开展用药咨询的体会

在门诊药房开设用药咨询窗口的传统做法固然可以在一定程度上为病人提供药学服务，但可能由于咨询者与病人之间存在一堵厚厚的墙而产生隔阂，又可能是病人的传统观念中存在对药房的错误理解，造成一方面前来用药咨询的病人数量较少，另一方面病人提出的问题中有相当数量是诸如“某某药药房有没有”、“某某药价格是多少”等。而这类问题完全可以由发药窗口和收费处来回答。作者通过仿效临床医师的诊疗方式，在上海东方医院门诊大厅开展用药咨询，取得了较好的效果，现报告如下。     

Clinical pharmacy services in the outpatient pediatric oncology clinics at a comprehensive cancer center

Background There is a need to expand clinical pharmacy services to cover the ambulatory pediatric cancer patients. There is a paucity of published literature describing pharmacy services in this setting. Objective To describe the development, implementation and the reported interventions of a clinical pharmacy service in the outpatient pediatric hematology?Concology clinics at a comprehensive cancer center in Jordan. Methods A stepwise approach was followed to develop and implement the described service. Four goals were set for the service comprising (1) ensure safe medication use (2) improve patient and caregiver education (3) enhance efficiency in medication distribution (4) facilitate the continuity of care across the inpatient and outpatient settings. The interventions collected were categorized into four major classes: clarification, safety, therapeutic and education. Results A total of 939 interventions were reported. Safety interventions were the highest with 500 (53%), followed by education 247 (26%), clarification 113 (12%) and therapeutic 79 (9%). The most common single interventions were patient counseling 247 (26%) and chemotherapy evaluation 229 (24%). Less frequent interventions were drug interactions and adverse drug reactions with 10 (1%) each. Conclusion Developing pediatric hematology?Concology clinical pharmacy services to cover the outpatient setting is essential to ensure continuity of care and to optimize therapeutics.     

门诊西药房创建优质药房的细节探讨

门诊药房是医院面对患者的重要窗口,在门诊西药房的工作中,要加强制度管理并坚决执行各项制度,同时加强药品管理、处方管理及药品调配管理,加强员工业务学习,提高员工服务技巧,教育员工树立正确人生观,通过咨询工作积累丰富的用药实践经验,监测和发现药物的不良反应,尽量少出差错,减少医患纠纷,向患者提供各层次、全方位的药物知识,提高用药的安全性、有效性和经济性。     

老龄化背景下居家药学服务开展现状及建议

目的 探讨老龄化背景下如何进一步提升居家药学服务质量。方法 总结近年来我国居家药学服务发展历程，分析当前居家药学服务开展的现状与局限。结果 我国的居家药学服务已从早期的各地区自主探索阶段逐步成熟规范，但其质量提升仍受多个瓶颈的制约，建议从加大药学服务普及力度、拓宽合理用药宣传渠道、优化药师队伍配置等方面加以改进。结论 促进居家药学服务质量提升对社区居家患者具有重要意义，需要多方共同致力完善。