处方合理性指标及其效度的研究

为了提高处方的质量和合理性，将规范处方这一措施引入到英国二级医疗服务中。Tully等选取了14项明确规定的指标，从医生的角度，对这一系列指标在内容效度和操作效度进行了研究。研究发现所有指标都具有内容效度；但由于病历等记录的资料不够全面，操作效度没能如期获得。     

处方合理性与合理用药指标间的关系研究

目的研究探讨处方合理性与合理用药指标间的关系,总结其临床意义。方法选取某院2009年7月至2011年7月收治的患者1816例,将其处方进行整理,对其合理性进行统计分析,并观察处方合理性与合理用药指标间的关系。结果 1816例处方中,存在不合理的有54例,占3.0%,其中以药物的用法用量的不合理率最高,占24.1%(13/54),其次为联合用药的不合理,占20.4%(11/54),与其他不合理用药指标比较有明显的差异(P<0.05),具有统计学意义;在众多影响用药合理性的因素中,抗生素使用种类、药费、年龄为主要的因素,期间有一定的相关性(r=0.31,0.32,0.40,P<0.05),具有统计学意义。结论某院处方的统计表明,处方用药方面基本合理,不合理率较低,但抗生素的不合理应用已成为临床上一个突出的问题,需要继续重视抗生素的临床应用问题,减少临床耐药,以促进合理用药,具有重要的临床意义。     

医院药品处方合理性评价体系构建及其分析研究

目的:通过对医院药品费用影响因素地分析,构建医院药品处方合理性的评价指标体系。方法:利用典型抽样与分层抽样相结合的方法,收集具有典型代表性病例;利用专家咨询的Delphi法,确立评价指标。结果:在对药品处方合理性影响因素分析时,筛选了5个一级指标和22个二级指标。结论:文章对药品处方的影响因素进行了筛选与量化,为改善药品处方合理性提供了重要的依据。     

门诊处方点评及用药合理性分析

目的：分析并总结我院门诊处方点评情况及用药合理性。方法：随机抽取2022年1月～6月我院门诊药房的2472张处方,依据药品说明书、《2010年医院处方点评管理规范（试行）》《处方管理办法》,对门诊处方的规范性、适宜性进行点评,统计不合理用药类型。结果：2472张门诊处方中,合理处方2287张,处方合理率为92.52%(2287/2472),不合理处方185张,不合理率为7.48%(185/2472),185张不合理处方共存在231个不合理原因,占比22.51%。结论：我院2022年1月～6月的门诊处方不合理率较高,不合理类型以不规范处方、不适宜处方、超常处方为主,临床药师需进一步加强对门诊处方的审核及点评力度,以保证门诊部合理用药。     

医院麻醉药品处方合理性调查分析

麻醉药品为强力镇痛剂或镇咳剂,是医疗、科研和教学不可缺少的一类药品.若麻醉药品管理和使用不当,可造成严重的社会问题.据中国药物依赖性研究所的新近报告,在13 044例药物成瘾者中,主要成瘾物质除海洛因外,哌替啶占4%(524例),还有少数人使用二氢唉托啡、吗啡、生阿片或阿片酊.当前,医疗应用最多的哌替啶,临床报道较长时间使用,不但能产生依赖性和耐药性,并可致中毒性精神病.为研究临床在麻醉药使用中存在的问题,预防社会流弊的发生,本文对1995年8月～2000年7月两家医院的麻醉药品处方进行全面调查总结,分析用药的合理性,为临床合理使用麻醉药品提供参考.     

基于主成份分析的医院药品处方合理性研究

目的:在建立医院药品处方合理性的评价指标体系基础上,对其影响程度加以归类与排序,为改善药品处方合理性提供重要的参考和依据。方法:利用主成分分析方法,对评价指标进行归纳性综合分析,对药品处方合理性进行系统分析论证。结果:按照贡献率大小进行排序,前6个主成分累计贡献率是85.39%。结论:将主成分分析方法引入药品处方合理性影响因素的分析,对药品处方的影响因素进行了筛选与量化,是一种有效方法。     

关于中药饮片处方点评及用药合理性分析

目的:本文将对我院2016年4月~9月的门诊中药房处方进行点评和分析,为规范我院中药饮片的合理应用提供可靠依据.方法:随机选取我院中药房300张门诊处方,并填写处方点评表,分类统计中药处方不合理用药情况.结果:在抽取的300张门诊处方中,处方合格153张,合格率为51%.共出现147张(49%)存在不合理用药问题,其中用药不适宜的80张(54.4%),不规范处方47张(32.0%),超常处方20张(13.6%).结论:对中药饮片处方进行点评,对我院临床医务人员的临床诊疗工作具有极为重要的现实意义,临床医师和药师应加强对中药饮片处方药合理应用的重视,尽快构建与中药饮片处方剂量先关的安全检测平台,主动肩负对患者中药饮片用药的责任,将中药处方不合格率降到最低.     

我院门诊处方用药评价

目的对我院门、急诊处方进行分析,对处方作出综合评价。方法从2007年11月～2008年10月每月随机抽取门诊100张处方,按《处方管理办法》中的有关项目进行统计、分析。结果我院门诊平均每张处方药物品种数为2.7;每张处方注射剂品种数为0.26;平均每张处方金额122.5元;平均每张处方抗菌药物品种数为0.316。结论我院门诊处方药物使用和管理基本合理。     

中西药联用处方的配伍合理性探析

目的 使临床中西药得到合理联用.方法 随机抽取我院2010年4月-2012年4月的800张中西药联用处方,对不合理的处方进行分类、统计及分析.结果 800张中西药联用处方中,共有69张不合理,其中不合理药处方约占3.8％,重复药方约占2.0％理化配伍禁忌处方约占1.5％,联用有药理配伍禁忌处方约占1.4％.结论 必须提高临床医师及药师的中药理论知识掌握程度,并加强对中成药处方的点评,注重医院管理水平的提高,提高中西药联用的合理性,以保障用药的安全性.     

甘肃省农村地区医疗用药合理性分析

目的了解甘肃省农村地区医疗机构的处方用药现状,为规范农村地区医生合理用药,提高医疗服务质量提供参考依据。方法采用分层整群抽样方法,调查甘肃省3个县、9个乡、27个村的医疗机构2014年的门诊处方,对抗生素使用、激素使用、处方及药品费用情况等进行统计分析。结果农村基层医疗机构中,门诊处方抗生素使用率在35%~64.58%。抗生素使用处方中,≥4种抗生素联合使用的处方主要见于妇幼保健院、乡镇卫生院和村卫生室,占比分别为0.27%、0.19%和0.14%;静脉滴注处方占比为30.73%,激素使用处方占比为3.07%;门诊处方基本药物、医保/新农合目录药品使用的平均水平分别是80.5%和80.6%。结论甘肃省农村地区在抗生素的使用和给药途径上还存在一定程度的不合理,要控制药品的不合理利用。     

Epidemiological surveillance of Creutzfeldt-Jakob disease in the United Kingdom

Systematic epidemiological surveillance of Creutzfeldt-Jakob disease was carried out in England and Wales covering the years 1970–1984. The results of this work provide a basis from which to assess any change in the pattern of Creutzfeldt-Jakob disease following the occurrence of Bovine Spongiform Encephalopathy. The methodology, early results and problems of the current systematic national survey of CJD, initiated in May 1990, are discussed.     

Potential arbovirus emergence and implications for the United Kingdom

Arboviruses have evolved a number of strategies to survive environmental challenges. This review examines the factors that may determine arbovirus emergence, provides examples of arboviruses that have emerged into new habitats, reviews the arbovirus situation in western Europe in detail, discusses potential arthropod vectors, and attempts to predict the risk for arbovirus emergence in the United Kingdom. We conclude that climate change is probably the most important requirement for the emergence of arthropodborne diseases such as dengue fever, yellow fever, Rift Valley fever, Japanese encephalitis, Crimean-Congo hemorrhagic fever, bluetongue, and African horse sickness in the United Kingdom. While other arboviruses, such as West Nile virus, Sindbis virus, Tahyna virus, and Louping ill virus, apparently circulate in the United Kingdom, they do not appear to present an imminent threat to humans or animals.     

International Recruitment of Nurses: Policy and Practice in the United Kingdom

Objective. To synthesize information about nurse migration into and out of the United Kingdom in the period to 2005, and to assess policy implications.
Principal Findings. There has been rapid growth in inflow of nurses to the United Kingdom from other countries. In recent years, 40–50 percent of new nurse registrants in the United Kingdom have come from other countries, principally the Philippines, Australia, India, and South Africa. Outflow has been at a lower level, mainly to other English-speaking developed countries—Australia, the United States, New Zealand, Ireland, and Canada. The United Kingdom is a net importer of nurses. The principal policy instrument in the United Kingdom, the Code of Practice on International Recruitment, has not ended the inflow of nurses to the United Kingdom from sub-Saharan Africa.
Conclusions. Given the increasing globalization of labor markets, it is likely that the historically high levels of inflow of internationally recruited nurses to the United Kingdom will continue over the next few years; however the "peak" number reached in 2002/2003 may not be repeated, particularly as large-scale active international recruitment has now been ended, for the short term at least. New English language tests and other revised requirements for international applicants being introduced by the Nurses and Midwives Council from September 2005 may restrict successful applications from some countries and will also probably add to the "bottleneck" of international nurse applicants. Demographic-driven demand for health care, combined with a potential reduction in supply of U.K. nurses as many more reach potential retirement age means that international recruitment is likely to remain on the policy agenda in the longer term, even with further growth in the number of home-based nurses being trained.     

Young people, gender and smoking in the United Kingdom

Over the last decade, gender has emerged as a significant differentiatorof smoking prevalence among young people in developed countries.Some attention has also been given to gender difference.s inmotives for taking up smoking. Compared to recent work on adultsmoking, the literature on smoking among young people has failedto take up the challenge of the analysis of gender differencesto highlight an interpretation of young people's smoking asa rational response to material and social pressures. This paperdraws mainly on questionnaire data from an ongoing UK studyof Adolescent Health and Parenting to outline an alternativeto the usual health education approach to young people's smoking.in this alternative model, the main factors associated withyoung people's smoking are material circumstances, life satisfactionand stress, including dissatisfaction with parental relationships,and peer sociability. Smoking is associated with poor reportedhealth status. The relationship between social factors and smokingin young men and women shows some significant differences, withyoung women being significantly more likely to smoke for stress-relatedreasons. Qualitative materialfrom a follow-up interview studyis indicative of the processes underlying the statistical associationsfound in the questionnaire     

中英全科医学教育现状的比较与思考

对中英全科医学教育模式、管理体制等方面进行了比较,并在借鉴英国全科教育模式的基础上,对我国全科医学教育的发展进行了探讨,建议进一步规范我国全科医学教育体系及其相应的资格认证制度,保障经费的投入及运作,建立一套具有中医药特色的中国全科医学教育体系。