社区药学人员基本技能岗位培训和考核方法初探

目的:探讨提高社区药学人员药学服务技能的岗位培训方法。方法:根据社区药学人员基本情况确定技能培训内容和方法并实施培训,通过技能考核和调查问卷了解技能培训和考核的效果。结果:绝大多数药学人员较好地掌握了规范化药品调剂、药物咨询和药品不良反应收集上报的基本技能,95%以上的人员认为参加药学技能培训对实际工作很有帮助。结论:建立社区药学人员定期岗位培训对于提高药学专业人员的知识水平和服务水平很有必要。     

我院254例药品不良反应/事件调查分析

目的：了解我院药品不良反应/事件(adverse drug reaction/Events,ADR/ADE)发生规律及特点,促进临床合理用药。方法：收集我院2013年上报的254例ADR/ADE报告,按照患者的年龄、药品种类、给药途径、药品不良反应累及系统-器官及临床表现、合并用药情况进行分类统计与分析。结果：254例ADR/ADE报告中以抗微生物药物的发生例次为首位,占37.66%;中药注射剂次之,占15.82%。静脉滴注是引发ADR/ADE的主要给药途径,占68.99%;ADR/ADE累及的主要系统-器官为皮肤系统,临床表现主要以皮疹、瘙痒为主。结论：应加强ADR相关知识的培训,提高临床医务人员对ADR/ADE监测工作的认识,增强上报意识,减少药品不良反应的发生,确保患者的用药安全。     

我院药品不良反应/事件主动监测系统构建

目的：构建药品不良反应/事件主动监测系统,为临床提供用药安全信息,及时发现并快速上报药品不良反应（adverse drug reaction,ADR）/事件（adverse drug event,ADE）,实现基于该系统的ADR/ADE真实世界研究条件。方法：联合"触发器原理"与"贝叶斯置信传播神经网络法"挖掘医院信息系统的ADR/ADE信号,由药师负责建立规则、布局功能模块以及对效果进行评估验证,由软件工程师负责编写计算机程序实现。结果：建立了较全面的监测规则,实现了实时预警与回顾性研究数据快速提取,完成了ADR/ADE主动监测平台的搭建。结论：ADR/ADE实时预警有利于及时处置,减少药品危害,并提高上报效能,快速筛选数据的功能为上市后药品安全性再评价提供便利,对建立药品安全性监测与评价信息技术平台有重要意义。     

我院近3年药品不良反应报告表质量分析

目的分析评估我院近3年来药品不良反应(adverse drug reactions,ADR)报告质量状况。方法根据《药品不良反应报告和监测管理办法》及"药品不良反应/事件报告表"规范分级标准,对我院512份ADR报告质量进行分析,包括报表的规范性、完整性、加分项的正确率分析,同时对ADR的上报科室和上报类型进行了统计。结果我院ADR报告表数量逐年上升,报表的完整性和规范性亦呈逐年上升趋势,主要是一般的不良反应,但总体报告表的质量仍偏低,主要体现在完整性不高。且ADR报表大部分由所在科室的临床药师上报,主要集中于抗生素和中成药注射液。结论 ADR上报应提高规范性、完整性及正确率。发挥临床药师的专业优势是提高ADR报告表质量的一个重要因素。     

某院肿瘤病区116例药品不良反应/事件报告分析

目的：研究我院肿瘤病区药品不良反应／事件（ADR／ADE）发生的特点,为临床安全用药提供参考。方法：收集2009～2012年我院肿瘤病区合格上报的116例ADR／ADE报告,分别从患者性别、年龄、给药途径、涉及药品种类以及ADR／ADE临床表现等方面进行统计并分析。结果：116例ADR／ADE,男性高于女性,40岁以上占96．6％;临床药师上报例数51倒（严重或新的ADR25例）,医师或护士上报65例（严重或新的ADR3例）。静脉滴注占79．0％,抗肿瘤药所致ADR／ADE最多,占27．3％,累及器官／系统以消化系统损害最为多见。结论：临床药师参与临床日常工作后,明显改进ADR／ADE的上报质量,发现了临床用药隐患,确保了用药安全。临床仍应加强ADR监测和报告工作,尤其是化疗药物,以减少ADR／ADE对患者的伤害。     

医院药学人员岗位再培训的实践与探讨

目的对药学人员进行有效的岗位再培训,确保其能高效、高质地完成工作,从而提高医院药学的服务水平。方法根据药学人员基本情况制订具体的岗位再培训计划、方式、内容并制作多媒体教学,对药学人员进行系统培训。结果岗位再培训后,96%以上的药学人员较好地掌握了专业基础理论知识及规范化药品调剂、药物咨询、参与临床用药指导等基本技能,大部分人员认为参加药学技能岗位再培训对实际工作很有帮助。结论开展岗位再培训工作十分必要,可调动药学人员的主观能动性,提高药学人员的知识水平和服务水平。     

中药药害与不良反应之探析

为合理使用中药,避免药害（drug misadventure,DM）和减少药品不良反应（adverse drug reaction,ADR）的发生,本文提出了中药DM与中药ADR的区别,并对此进行了分析阐述,探讨了相应对策。认为医师用药不当、患者对中药治疗的不依从性及药物本身原因都可造成中药ADR及不良事件（adverse drug event,ADE）的发生。临床使用方法得当,就可以避免中药DM和减少中药ADR的发生。     

182例新生儿药品不良反应分析

目的 探讨新生儿药品不良反应(adverse drug reaction,ADR)发生的原因、特点及影响因素,以减少新生儿ADR的发生,促进新生儿临床合理用药.方法 对2006年10月1日至2019年12月31日我院收集上报的182例新生儿ADR进行统计分析;计算各类药物ADR严重度指数(adverse drug re...     

医院2019—2021年度中药注射剂药品不良反应/不良事件情况分析

目的 对中药注射剂药品不良反应/不良事件(ADR/ADE)进行回顾性分析,以促进临床合理用药。方法 统计分析2019年1月—2021年12月江苏省江阴市人民医院上报国家药品不良反应中心的中药注射剂ADR/ADE报告表数据,所涉及患者共93例。总结患者的用药情况,分析ADR/ADE特征。结果 共收集中药注射剂ADR/ADE病例93例,其中ADR/ADE严重程度分级：一般67例,严重8例,新的一般或新的严重18例;ADR/ADE上报人员角色分布：医师70例,护士16例,药师7例;ADR/ADE报表质量等级：4级报表61例,3级报表28例,2级报表4例。涉及ADR/ADE的中药注射剂共15种,以疏血通注射液、苦黄注射液、注射用血塞通(冻干)等为主;性别发生ADR/ADE无差异,但>51岁者有69例(74.19%),与其他年龄比较差异有统计学意义(P<0.05);ADR/ADE主要累及6个系统或器官,以皮肤及其附属腺体最为常见,其次是消化系统和全身反应。ADE主要以溶剂种类、溶剂用量、药品用量及给药频次为主;ADR/ADE主要发生在用药30 min内,大多数临床症状较轻,且预后较好...     

科学培育规范管理,建立稳步发展的临床药学服务团队——吉林大学第二医院临床药学实践

吉林大学第二医院药品管理部是负责全院临床用药管理和实施药学技术服务的重要科室,是集药品供应、药事管理、临床药学、教学科研一体化的综合性科室,始终以确保合理用药为宗旨开展各项工作。1科学合理的岗位培养与人才梯队建设发展以人为本,人才以用为本,为了培养和造就结构合理、素质优良的临床药学人才队伍,根据业务范围和实际需求,逐步设立了专科临床药师、信息药师、ADR监测员、抗菌药物监测员、绩效管理员和教学科研秘书等临床药学岗位。并成立了由科室骨干和相关人员组成的药物咨询小组、处方点评小组、医嘱点评小组、     

北京地区多基地联合培养疼痛专业临床药师的实践

目的：探索北京地区疼痛专业联合培养临床药师模式的前提条件和所面临的困难,以期为临床药师培养模式的改革提供参考。方法：查看学员在各基地的轮转计划,分析单基地与多基地培养模式是否能覆盖培训大纲重点要求的病种;考察联合培养模式对疼痛专业学员的案例考核和培训过程评分的影响;对已经参加多基地联合培养的20名疼痛专业学员进行问卷调查,分析联合培养模式的优势与劣势。结果：参与联合培养的3家培训基地在疼痛治疗领域各有特色,但各个基地均难以独立完全满足教学大纲的培训要求。多基地联合培养在优势学科互补、优势师资互补、优势资源互补方面优势明显,联合培养可使学员全面掌握诊疗知识和实践技能。联合培养不能显著提升培训学员的案例考核成绩,但对培养过程成绩具有显著的提升作用[（95.66±2.67） vs.（90.11±5.58）,P=0.016]。参加多基地联合培养的2期学员共有20名,问卷收回20份。学员对联合培养模式的综合满意度为100%;各分项调查中,在联合基地学习诊疗知识的满意度最高,为95%,前往联合基地的通勤压力的满意度最低（30%）。结论：疼痛专业临床药师的多基地联合培养模式弥补了各基地的缺点和不足,让学员能够全面掌握疼痛相关诊疗知识与实践技能,达到优势学科共享、优势资源共享、优秀师资共享的目的。但学员的通勤压力是联合培养模式面临的最大难题。     

中药临床药师培训结业学员返岗工作现状调研

目的了解中药临床药师培训结业学员返岗后的工作现状。方法采用"问卷星"在线调研平台,通过微信方式向已结束中药临床药师培训的学员发放调查问卷,收集结业学员的工作地、所在医院级别、年龄、职称等基本信息,以及返岗后的工作去向、工作内容、临床认可度、培训建议等信息,分析结业学员的工作现状。结果中药临床药师培训学员已覆盖全国30个省、自治区、直辖市,共结业878人,回收调查问卷757份。学员返岗后从事临床药学工作的占77.94%;每周参与临床工作时间占比超过1/2周的仅25.25%,主要原因是科室其他事务繁忙,学员认为能胜任自身工作或能获得临床认可的分别占97.80%和73.73%,92.71%的学员愿意继续从事临床药学工作;96.30%的学员觉得培训非常受益,对培训基地的建议主要集中在培训内容、培训方式、带教等方面。结论绝大部分学员中药临床药师培训结业学员返岗后愿意并能从事临床药师工作,培训基地将不断优化培训模式和内容,努力为中药临床药师行业的发展贡献力量。     

Family health services authorities and community pharmacists at the purchaser-provider interface

The views of both purchasers (family health services authorities [FHSAs]) and providers (community pharmacists) were sought on the development of community pharmaceutical services in the light of the 1992 pharmaceutical care report. Questionnaires were posted to the 480 pharmacists in charge of all community pharmacies in Wessex and to the 98 general managers of FHSAs in England and Wales. The questionnaires focused on reactions to those recommendations of the pharmaceutical care report which, if implemented, would have significant implications for the community pharmacist's workload. Both the FHSAs and community pharmacists indicated that, in their view, the skills of the community pharmacist are currently underutilised. Both groups expressed enthusiasm for the pharmaceutical care report recommendations that the following services should be provided: domiciliary services, disposal of unwanted medicines, supply of aids for disabled people, supply of compliance aids and adverse drug reaction reporting. Neither group was enthusiastic about pharmacists providing a therapeutic drug monitoring service from community pharmacies. On other areas, pharmacists were more enthusiastic about the provision of health advice, diagnostic/screening services and treatment protocols, while FHSAs favoured distribution of welfare foods, needle exchange, instalment dispensing and referral forms. Overall, both the FHSAs and community pharmacists were receptive to the principle of the development of the role of the community pharmacist within the primary health care team but expressed concerns regarding the training and workload implications.     

以需求为导向的重庆市基层药师培训模式研究与实践

目的：依托重庆市基层药学师资基地培训项目,为重庆市各基层医疗机构培养优秀的基层药师。 方法：对重庆市142名基层药师实施需求为导向的药学服务能力培训。培训前普遍调研学员需求,按照调研结果合理设置课程,实施培训并进行理论和技能考核。结果：圆满完成重庆市基层药师培训任务,参训学员基本掌握了规范化药学服务技能,能胜任基层医疗机构的药学服务工作。结论：以需求为导向的基层药师培训模式取得了较好成效,具有较好实用性和推广意义。     

Development, validation and implementation of continuous professional development programmes for community pharmacists

In India, structured continuous professional development modules are not available to update the knowledge and skills of the practicing community pharmacists. A prospective study was designed to develop, validate and implement continuous professional development modules and to assess the impact of training programme on knowledge and skills of community pharmacists. Modules were developed by referring to standard texts and data bases and were validated for the content. The impact of training programme on pharmacists' knowledge and skills was assessed using suitably designed pre and post training knowledge attitude and practice questionnaires, pre and post training questionnaires for individual continuous professional development training sessions, pre and post training patient counseling skill assessment, blood pressure measurement skill assessment and capillary blood glucose check-up skill assessment check-lists. Data was analyzed by applying suitable statistical methods using InStat version 3.01 statistical software. Fourty eight community pharmacists were enrolled in to the study. A statistically significant (P<0.05) improvement was observed in post training knowledge attitude and practice scores and in post training scores of individual training sessions. A statistically significant (P<0.05) improvement was also observed in post training scores of professional skills such as Patient counseling, capillary blood glucose recording and blood pressure measurement skills. The study findings conclude that continuous training updates the knowledge and skills in practicing the pharmaceutical care in their pharmacies.     

住院药房药师分层培训计划的构建

目的： 基于住院药房各类药师岗位胜任力的要求，为确保工作间所有新员工的带教工作全面、统一、有序执行，探索药师分层培训的具体培训计划的构建。方法： 积累并记录各类药师工作实际内容和教学要点，通过住院药房教学小组共同讨论，形成住院药房药师分层培训计划。结果： 形成住院药房培训计划共68条目，将培训内容和时长分为三层。规范化培训药师培训内容最多、时间最长，药品调配、药品管理和用药合理性并重；药师（包括合同制药师）注重药品调配和药品管理；药工注重药品调配相关工作技能。结论： 构建覆盖全部新职工、统一而分层的培训计划，有助于提升住院药房培训质量、促进分工合作、提升药师胜任力。     

基于成果导向教育理念的临床药师培养模式创新与实践

目的 探索临床药师培养的新模式,培养更加具有实践能力的临床药师。方法 根据实际情况,采用成果导向教育(outcome based education,OBE)培养模式,以临床药师岗位胜任力为培养目标,结合临床和药学教育资源,制定培养计划并构建多元化考核体系,评价2019-2020年36名学员在基本技能、药学专业素质、药学服务能力、临床基础水平、科研能力5个维度的学习成效。结果 学员认为基于OBE理念,培训后5个维度的分值明显提高,平均分值最多提高4.39分,考核专家及带教老师对学员各维度的评分均>6分。结论 OBE理念下的临床药师培养模式能够满足临床药师培训的要求,有助于临床药师教学水平的提高,也有助于学员实现药学知识、临床基础、实践技能等综合素养的全面提升。     

Evaluation of online training for the provision of opioid substitution treatment by community pharmacists in New Zealand

Introduction and Aims. The role of community pharmacists in the provision of opioid substitution treatment (OST) is pivotal and integral to addiction treatment. An online training program for pharmacists in OST management was piloted in New Zealand in 2010, following recognition of the difficulty in recruitment and retention of community pharmacists to provide OST services. Our aim was to evaluate the OST online training that was made available for any community pharmacist in New Zealand and to establish the feasibility and acceptability of this format of training for community pharmacists. The evaluation explored participants' attitudes, skills and knowledge both pre‐ and post‐training in OST. Design and Methods. All pharmacists registering to participate in the training program were asked to complete an evaluation questionnaire immediately before (pre) and immediately after (post) completing the training. Participants were also invited to participate in a brief 10 min structured telephone interview about their training experience. Results. In the first 4 months 190 pharmacists commenced the training; 101 completed both evaluations. Improvements in the confidence and skills of pharmacists were demonstrated through both the quantitative and qualitative analyses. Statistically significant changes in attitudes were also demonstrated. Overall the OST training was well received and the online format was feasible and highly acceptable. Discussion and Conclusion. Online training is an appropriate and economical method of improving pharmacists' clinical skills with respect to this client group, and has the potential to reach a wider audience of pharmacists. Further research is required to investigate OST client experiences in community pharmacy.[Walters C, Raymont A, Galea S, Wheeler A. Evaluation of online training for the provision of opioid substitution treatment by community pharmacists in New Zealand. Drug Alcohol Rev 2012;31:903–910]     

A web-based training program to support chronic kidney disease screening by community pharmacists

Background Community pharmacists’ role in screening of several chronic diseases has been widely explored. The global health burden of chronic kidney disease is high; however, the progression and adverse outcomes can be prevented or delayed by detecting and treating the disease in its initial stages 1–3. Therefore, a web-based training program was developed to enhance pharmacists’ knowledge and skills required to perform a chronic kidney disease screening service in a community setting. Objective The aim of this study was to evaluate the impact of a web-based training program on community pharmacists’ knowledge and skills associated with chronic kidney disease screening. As secondary aim, pharmacists’ satisfaction with the training program was assessed. Setting Community pharmacy practice. Method A web-based training program was developed by four pharmacists and a nephrologist. Quantitative data was collected by employing a self-administered, web-based questionnaire, which comprised a set of five multiple-choice knowledge questions and one clinical vignette to assess skills. A nine-item Likert scale was used to determine pharmacists’ satisfaction with the training program. Main outcome measure Pharmacists’ knowledge and skills scores at pre and post-training, reliability of the Likert scale, and the proportion of responses to the individual nine items of the satisfaction survey. Results Fifty pharmacists participated in the pre-questionnaire and 38 pharmacists completed the web-based training and post-questionnaire. Significant differences were observed in the knowledge scores (p < 0.001) and skills scores (p < 0.001) at pre- and post-training. Cronbach’s alpha for the nine-item satisfaction scale was 0.73 and the majority pharmacists (92.1–100 %) were satisfied with the various aspects of the training program. Conclusion The web-based training program positively enhanced pharmacists’ knowledge and skills associated with chronic kidney disease screening. These findings support further development and widespread implementation of the training program to facilitate health promotion and early identification of chronic kidney disease in a community setting.