Development of a pharmacy residency program in home care.

A residency training program developed by a college of pharmacy in conjunction with a home care company is described. The 12-month program is based on the ASHP Residency Learning System and the goal statements and educational objectives of ASHP's accreditation standard for pharmacy practice residency training with emphasis in home care. Establishing the program involved identifying goals, objectives, and learning experiences consistent with the expected outcomes. Specific objectives for meeting goals in four categories--practice foundation skills, direct patient care, drug information and drug policy development, and practice management--were linked to expected program outcomes. Learning experiences that would lead to achievement of the program objectives and outcomes were selected and organized into one- to eight-week rotations (e.g., in acute care, care of pediatric patients, pain management, nutrition, patient education and counseling, and administration and practice management). Throughout the program, residents gain experience in pharmaceutical services and research. Skills in care planning and monitoring are emphasized, as is practicing pharmaceutical care in an interdisciplinary environment. Residents who have completed the program have found employment immediately as pharmacy managers of home infusion centers. Pharmacy residency training in home care provides the experience needed to function as a competent clinician and manager who can identify and solve problems to improve patient care.     

A quality assurance program for clinical pharmacy services provided to a long-term care unit in a community hospital.

This paper describes the development of a quality assurance program for the clinical pharmacy services being provided to a long term care unit in a community hospital. The functions, standards and criteria of these clinical services are presented and the results and impact of four completed audits are discussed. It is the intent of this article to demonstrate the ease with which a quality assurance program for clinical pharmacy services may be instituted and the potential benefits it may offer.     

Clinical pharmacy services in a hospital-based home care program

The Hospital-Based Home Care (HBHC) Program at the Veterans Administration Medical Center in San Francisco, California, is a specialized medical service designed to provide comprehensive continuity of care to the veteran patient in his or her own home through the use of a multidisciplinary team approach. Professional health care services are provided by nurses, dieticians, physical therapists, pharmacists, physicians, and social workers. Professional services provided by the clinical pharmacists include: the evaluation of prescribed medication regimen; product identification; patient counseling and education; drug therapy consultant to the HBHC team; and liaison between the HBHC team and outpatient pharmacy services.     

过渡期护理模式在重度颅脑损伤患者重症监护过渡护理中的应用

目的探讨过渡期护理模式(TCM)在重度颅脑损伤患者过渡阶段的护理效果及护理满意度的影响。方法选择2017年1月～2018年6月在我院ICU治疗的120例重度颅脑损伤患者,后均转入神经外科普通病房进行治疗,将所有患者随机分为对照组和观察组,每组60例。对照组患者在过渡期给予常规护理,观察组患者采用过渡期护理模式,观察两组患者在过渡期不良事件发生率、重返ICU率、焦虑评分(SAS)、抑郁评分(SDS)、住院时间以及患者的格拉斯预后(GOS)优良率、MMSE评分、NFD评分及护理满意度。结果观察组患者的不良事件发生率、重返ICU率、SAS评分、SDS评分、NFD评分均明显低于对照组(P 0.05),观察组患者的住院时间明显少于对照组(P 0.05);但观察组患者GOS评分优良率、MMSE评分及护理满意度均明显高于对照组(P 0.05)。结论重度颅脑损伤患者在过渡期采用TCM护理干预,能够有效降低患者的不良事件发生率,改善患者不良情绪,促进患者认知功能恢复,减轻神经功能缺损,促进患者更快康复出院,提高患者及家属的护理满意度。     

我国药学会诊文献分析

目的:通过相关的文献分析,探讨我国药学会诊工作的发展状况和存在的问题,为临床药师从事药学会诊工作提供参考。方法:检索1989—2014年中国期刊网全文数据库(CNKI)、万方医学数据库、维普数据库药学会诊相关文献,利用Excel表格进行汇总分析。结果:共得到文献148篇,文献量呈逐年增长趋势,大部分文献发表在2009年以后,2009—2014年文献量共134篇,占总文献量的90.5%;个案实践体会类文献数量最大,占总文献量的55.4%,汇总回顾分析类文献近年来增幅较快;三级医院文献121篇,占总文献量的81.8%,明显高于二级医院;文献第一作者大部分具有中、高级专业技术职称,相对集中在江苏、广东、北京、上海、湖南、四川等经济较发达和医疗水平较高的区域;大部分文献发表在药学核心期刊上,中国科技核心期刊收录的文献占总文献量的62.6%;文献中涉及的案例会诊内容不广泛,主要以抗菌药物为主。结论:我国药学会诊工作起步较晚,前期发展缓慢,但从2010年后发展比较迅速,临床药师会诊工作的能力和水平逐年提高,药学会诊工作逐渐得到了医院管理层面和临床医师的支持和认可,但药学会诊工作的广度和深度均需加强,相关文献的研究水平有待提高。     

Pharmacokinetic consultation program in a pediatric asthma clinic.

The effect of a clinical pharmacokinetic consultation program for theophylline on the outcomes of pediatric patients with asthma was studied. The program was established in 1989 at a pediatric asthma clinic. For each patient visit, a clinical pharmacist recorded demographic, clinical, and medication-related information and counseled the parents. When an adjustment in the theophylline dosage was indicated, the pharmacist calculated the appropriate dosage using population pharmacokinetic values. If the pediatrician requested a measurement of the serum theophylline concentration, the time when the blood sample was drawn relative to the last dose was recorded, an average serum theophylline concentration at steady state and individualized pharmacokinetic values were calculated, and the dosage was adjusted accordingly. Patient data were compared among three stages: (1) the month before and the month of entry into the program, (2) months 5 and 6 after entry, and (3) months 11 and 12 after entry. A total of 44 patients were studied during each of stages 1 and 2, and 29 patients were reviewed during stage 3. There was a significant improvement in wheezing from stage 1 to stage 2 and in exercise tolerance and nocturnal coughing from stage 1 to stage 2 and stage 1 to stage 3. Forced expiratory volume in one second improved significantly from stage 1 to stage 2, and there was a significant reduction in the necessity for hospital visits for the treatment of exacerbations of asthma between stages 1 and 2. The daily weight-adjusted dose of theophylline increased significantly after the program began. Asthmatic children taking theophylline had improvements in outcome variables after pharmacokinetic consultation and medication counseling were initiated.