应用中药引发的药患纠纷及防范措施

目的:规范药学服务,避免药患纠纷。方法:将我院近年来发生的药患纠纷按类型归纳、分类,分析产生的具体原因,并建立相应的防范措施。结果:引起药患纠纷的因素,主要与药师、医师的工作责任心、综合服务素质及相互之间的沟通有关;通过采取制度化管理、规范化操作、人性化关怀及提高沟通技巧等措施,可避免药患纠纷的发生。结论:中医药工作人员在医疗服务过程中,树立"以患者为中心,以提高医疗服务质量为目标"的宗旨,是防范医患、药患纠纷的关键。     

门诊药房药患纠纷的处置预案与技巧

目的：建立门诊药房药患纠纷处置预案,提高门诊药房对纠纷的应急处理能力。方法：分析药患纠纷产生的原因,根据门诊药房的工作特点和工作中的处理经验建立具体的药患纠纷处置预案,并总结药患纠纷的处置技巧。结果：药惠纠纷的原因包括药师、患者、医院其他部门等方面因素。处置预案需坚持“大事化小,小事化了”,坚持“无限沟通”原则。处置过程中需掌握倾听、换位思考、无限沟通等技巧。结论：门诊药房建立药患纠纷处置预案、掌握药患纠纷处置技巧是非常必要的,能及时有效地化解矛盾、解决纠纷,最大程度地降低药患纠纷造成的影响和损失。     

医院药患关系探讨

药患关系是医院医患关系中的重要组成部分,药房是医疗活动过程中最后环节,也是最易发生药患纠纷的场所,如处理不好药师与患者的关系,患者有可能将在医院诊治过程中的不如意均发泄在药师的身上,而产生药患纠纷,所以解决好药患关系,对提升医院的形象、提高患者对医院的满意度具有重大的意义[1]。现将药患关系产生的原因报道如下。     

门诊药房药患纠纷原因分析

门诊药房是医院的一个重要窗口,药师与患者的关系是病人在整个诊疗过程中的重要组成部分,如果药师未处理好药患关系而导致纠纷,虽不直接参与诊疗活动,也会影响患者的身心健康,还会间接影响医院声誉,甚至医院的发展。避免发生药忠纠纷,构建温馨和谐的药患关系,将有利于药学服务的发展,有利于提高医院的整体水平,笔者通过在门诊药房工作的一些体会,从药房的工作性质、药忠纠纷易发生的原因、以及改进措施等方面进行论述。     

某三级医院药患纠纷产生原因及处置措施

目的通过减少医院药房差错及药患纠纷,改善药患关系,提高医院服务质量,建立和谐的医疗环境。方法对门诊药房差错及发生的药患纠纷进行登记,包括产生的原因、采取的对策及干预的结果,并进行分析总结,制定相应的干预措施,如制定"处方/医嘱提示"便签告知相关人员。结果引起药患纠纷的原因主要有医院管理因素、医师因素、药房工作人员因素、收费工作人员因素、患者自身因素和药品因素等。通过制定"处方/医嘱提示"便签,设置纠纷处置程序,制定相应对策,能快速有效地化解矛盾,解决纠纷。结论坚持"以患者为中心,让每一个患者满意"的服务宗旨和理念,加强医院内部的沟通和管理,能有效减少甚至杜绝药患纠纷,提高医院服务质量。     

门诊药患关系分析

药患关系是医患关系的重要组成部份,药房是医疗活动中最后环节,如果药师未处理好药患关系,而导致纠纷,患者有可能将在医院诊治过程中的一切不如意全部发泄在药师的身上,而导致药患纠纷,影响医院的声誉,甚至医院的发展,分析引起药患纠纷的原因,提出应对措施,改善药患关系,提高服务质量。     

新医改环境下医院药患纠纷成因及防范措施

减少和避免新医改环境下医院药患纠纷,提高服务质量,改善药患关系。根据新医改环境下药患纠纷产生的根本原因,采取相应范措施,加以多因素先期干预。药师在医疗、财务等多部门的配合下,转变服务观念,改善服务态度,落实各项规章制度,不断提高药师服务质量是防范和减少药患纠纷的根本措施。     

农村基层医院门诊药房药患纠纷成因分析及处理

目的减少药师和患者之间的纠纷，增加相互间的信任度。方法分析农村基层医院门诊药房的主要工作特点，对药患纠纷的成因进行分析，并提出针对性解决方法。结果与结论药师必须改善服务态度和提高服务技巧，增强职业道德修养。医院药房有必要采取措施，以改善药患关系。     

医院门诊药房药患纠纷分析及应对措施

目的分析医院门诊药房药患纠纷产生的原因,明确存在的问题,分析导致这些问题的原因,并提出应对措施。方法根据我院门诊药房收集的信息反馈,从医院层面、药师层面以及患者层面分析,探讨产生原因及解决方法。结果药患纠纷的发生与医师因素(处方不规范、开错处方)、药师因素(服务态度不佳、调剂差错等)、患者因素、退药因素、药品价格因素等有关。结论为预防药患纠纷的发生,需要有针对性地制定有效措施逐步解决现存的主要问题,加强门诊药房的流程优化再造,并适时实施条形码扫描发药系统。     

门诊药房常见药患纠纷案例分析及解决方案探讨

目的：探讨解决药患纠纷的科学方法,建立药患双方的和谐关系。方法：对药患纠纷的个案进行分析并提出处理要点。结果：本文将引发门诊药房常见药患纠纷原因分为：药品质量问题、药师服务不到位、医师原因、患者自身原因、医院部门之间协调欠妥等五个方面,针对上述原因采取了加强药品质量管理、提高服务质量及服务意识、加强药患沟通和患者教育、优化内部流程等多项方案。结论：方案的实施,最大程度避免了纠纷的出现,也使已出现的纠纷得到有效解决,达到了构建和谐药患关系的目的。     

Community pharmacist's perspective regarding patient-centred communication in conjunction with pharmaceutical practice: A cross-sectional survey

Effective communication between pharmacists and patients is essential for therapeutic success. The pharmacist's perspective may differ from that of the patient in terms of effective communication. Our study aimed to assess the communication efficiency in the pharmacist-patient relationship from the pharmacists’ perspective. We hypothesize that the community pharmacist's perspective can lead to relevant aspects of patient-centred communication and their profession. A cross-sectional study was conducted through an online questionnaire addressed to pharmacists. A number of 506 questionnaires were collected, evaluated, analyzed and interpreted. The questionnaire focused on the following main issues: degree of job satisfaction, essential skills of a pharmacist working in a community pharmacy, different aspects of pharmacist-patient communication, shared decision-making, patient monitoring plan and other elements related to a patient under treatment (healthy lifestyle, receptivity to counselling, loyalty and appreciation of pharmaceutical services). The pharmacist's efficiency in communication with the patient and professional education were also targeted in the study. There are no significant differences between job satisfaction in women compared to men. However, the job satisfaction increases with the average age. Caregiver, communicator and life-long learner were identified as essential skills of a pharmacist. Pharmacists participating in the study generally perceive themselves as good communicators with the patient. Nevertheless, many particular aspects of communication with patients can be greatly improved. The lack of training in the spirit of the ?patient-centred communication” concept has been identified. Still, more than a third of the respondents are missing the need for professional training. A periodic evaluation of the efficiency of pharmacist-patient communication in the community pharmacy is necessary. The degree of subjectivity of the pharmacist from this perspective and self-sufficiency would be significantly diminished if the pharmacists had access to the results of the periodic evaluations.     

门诊药房投诉原因分析与解决措施

目的分析我院门诊药房投诉产生的成因,为改善我院药患关系、提高窗口服务水平寻找解决对策。方法根据我院门诊药房的工作情况和对患者抽样调查的信息反馈,从医院层面、药师层面以及患者层面分析,探讨投诉产生原因及解决方法。结果门诊药房工作人员药学服务不到位,业务水平不够熟练,患者对门诊药房缺乏了解,取药等候时间过长,药房人员与患者之间沟通交流不够,导致患者投诉的产生。结论门诊药房工作人员应提高自身素质,改变服务理念,改进业务水平,加强与患者间的交流,是和谐药患关系的关键。     

浅论医院药师与患者的沟通

目的 :促进我国医院药师与患者的沟通 ,充分发挥药师在药物治疗中的作用。方法 :论述药师与患者沟通的意义、特点和模式 ,分析阻碍药师与患者沟通的因素。结果 :针对我国医院药师与患者沟通的现状 ,提出了加强药患沟通的策略。结论 :医院药师与患者进行沟通是药学监护的需要 ,具有重要意义 ,应予以加强。     

我院门诊药房药患纠纷发生的原因分析及预防措施

目的:为减少药患纠纷,改善药患关系提供借鉴。方法:抽取2007年10月-2008年10月在"药患纠纷登记本"登记的药患纠纷共126例,将其归纳、分类,分析发生原因并提出预防措施。结果与结论:药患纠纷的发生与药房及药师因素(服务态度不佳、用药指导不力、调剂差错等)、医师因素(处方不规范、开错处方等)、退药因素、药品价格因素、收费处因素、患者因素等有关。为预防药患纠纷的发生,应严格遵守操作规程,改变服务观念,加强与患者沟通,建立处方质量控制小组监督合理用药,开设药物咨询窗口,建立严格管理制度,同时在诊疗过程中树立"以患者为中心,以提高医疗服务质量为目标"的宗旨提供全方位的药学服务。     

Pharmacists' communication with Spanish-speaking patients: A review of the literature to establish an agenda for future research

BackgroundSpanish-speaking people represent more than 12% of the total population in the United States and are poised to become the largest minority group in the United States by 2015. Although researchers have studied pharmacist-patient communication for approximately 30 years, little emphasis has been placed on the interactions between pharmacists and Spanish-speaking patients.ObjectivesThe objectives of this review are (1) to describe empirical studies on Spanish-speaking patient/pharmacist communication examined relative to patient factors, pharmacist factors, and environmental factors that may influence Spanish-speaking patient/pharmacist communication and (2) to integrate medical and nursing literature to generate a research agenda for future study in this area.MethodsWe compiled articles from a systematic review of (1) CINAHL, International Pharmacy Abstracts, PubMed, and Web of Knowledge databases using “Hispanic limited English proficiency,” “Latino limited English proficiency,” “language-assistance services,” “Spanish-speaking patients,” “Latino patients,” “Spanish-speaking health literacy,” “pharmacy health literacy,” “patient-provider communication,” “pharmacy language barriers,” and (2) bibliographies of selected articles.ResultsThis search generated 1174 articles, 7 of which met the inclusion criteria. We categorized the results into 4 topic areas: “Spanish-speaking patient literacy,” “pharmacists knowledge of/proficiency in the Spanish language,” “pharmacy resources to overcome language barriers,” and “pharmacists' attitudes toward communicating with Spanish-speaking patients.”ConclusionsThese studies provide a macroscopic look at the linguistic services offered in pharmacies, gaps in services, and their subsequent impact on pharmacists and patients. Future research should investigate Spanish-speaking patients' literacy issues, pharmacy staff language skills, factors that influence pharmacists' counseling, and language-assistance programs for pharmacists and patients. Furthermore, these studies need to be conducted in large Hispanic/Latino populated areas where positive service models are likely to be present. Addressing these issues will provide pharmacists and pharmacies with information to overcome language barriers and provide Spanish-speaking patients with quality care.     

Identifying caring behaviors of pharmacists through observations and interviews.

OBJECTIVE: To identify caring behaviors of community pharmacists demonstrated in the pharmacist-patient interaction. DESIGN: Qualitative research. SETTING: Five community pharmacies in the Greater Chicago area. PARTICIPANTS: 8 pharmacists identified as "caring pharmacists" by corporate managers and 13 pharmacy technicians. INTERVENTIONS: Observations of pharmacy personnel interacting with patients and interviews of 2 pharmacists. MAIN OUTCOME MEASURES: Caring behaviors. RESULTS: Four categories of caring behaviors emerged from the observation field notes: physical behaviors (leaning toward patient, smiling, looking patient in eye), relationship behaviors (greeting patients, knowing name, making small talk), task behaviors-nonpharmacy (explaining receipt and money transaction), and task behaviors-pharmacy (providing information, calling physician, asking about allergies and explaining interactions). In interviews, pharmacists said that a caring pharmacist was about "being for the patient," and both noted that caring pharmacists greet the patient, inquire about the patient's health and family, and are sincerely interested in the patient. Mentors and family members are important in developing caring pharmacists, the pharmacists said. CONCLUSION: Specific caring behaviors identifiable among pharmacists and pharmacy technicians. These behaviors can be modeled by pharmacy managers and should be taught in pharmacy schools.     

Older patient, physician and pharmacist perspectives about community pharmacists' roles

Objectives To investigate older patient, physician and pharmacist perspectives about the role of pharmacists in pharmacist-patient interactions. Methods Eight focus-group discussions were held in senior centres, community pharmacies and primary care physician offices. Participants were 42 patients aged 63 years and older, 17 primary care physicians and 13 community pharmacists. Qualitative analysis of the focus-group discussions was performed. Key findings Participants in all focus groups indicated that pharmacists are a good resource for basic information about medications. Physicians appreciated pharmacists' ability to identify drug interactions, yet did not comment on other specific aspects related to patient education and care. Physicians noted that pharmacists often were hindered by time constraints that impeded patient counselling. Both patient and pharmacist participants indicated that patients often asked pharmacists to expand upon, reinforce and explain physician-patient conversations about medications, as well as to evaluate medication appropriateness and physician treatment plans. These groups also noted that patients confided in pharmacists about medication-related problems before contacting physicians. Pharmacists identified several barriers to patient counselling, including lack of knowledge about medication indications and physician treatment plans. Conclusions Community-based pharmacists may often be presented with opportunities to address questions that can affect patient medication use. Older patients, physicians and pharmacists all value greater pharmacist participation in patient care. Suboptimal information flow between physicians and pharmacists may hinder pharmacist interactions with patients and detract from patient medication management. Interventions to integrate pharmacists into the patient healthcare team could improve patient medication management.     

The use of consultation skills assessment tools in pharmacist‐patient consultations

Objective The consultations assessed in this study occurred as part of a larger randomised controlled trial (the HeartMed trial) which was evaluating the impact of home visits by pharmacists to patients with heart failure. Pharmacists are increasingly being expected to take on roles involving extended interviews with patients, but while the doctor‐patient consultation has been well researched, such analysis has rarely been undertaken in pharmacy practice. The aim of this study was to analyse the consultation skills used by pharmacists using two validated consultation skills assessment tools (the Henbest and Stewart rating scale and the SEGUE score), and to assess the applicability of these tools to the pharmacist‐patient consultation. Setting The study involved pharmacist consultations with patients who were aged over 18 years, living in independent accommodation and were prescribed two or more medicines taken on at least a daily basis. These patients were recruited to the HeartMed trial during an acute admission to hospital with heart failure, and were visited by a pharmacist during the first six weeks following hospital discharge. Method The pharmacist‐patient consultations were tape‐recorded, transcribed and evaluated using two different consultation skills tools — the Henbest and Stewart rating scale which assesses ‘patient centredness’ and the SEGUE score which assesses the content of the consultation. Key findings Both consultation skills tools were easily applied to the pharmacist‐patient consultations. The pharmacists scored well on both the tools despite relatively little formal training. Conclusions Existing consultation skills tools can be used to assess pharmacist‐patient consultations.