未担任临床工作的医院药学人员成为临床药师的必要性与可行性分析

目的： 目前我国临床药师数量短缺现象较为严重，医疗机构中未担任临床工作的药学人员成为临床药师可能是改善我国临床药师人力资源储备的措施之一。本研究旨在分析未担任临床工作的医院药学人员成为临床药师的必要性与可行性。方法： 通过文献研究的方法分析我国未担任临床工作的医院药学人员成为临床药师的必要性与可行性。结果： 医院药学向临床转型是目前的趋势，未担任临床工作的医院药学人员成为临床药师具有药学知识充足、熟悉医院药学工作流程、转型便捷高效等优势，能够弥补临床药学专业教育在人才输送方面存在的不足，具有很强的必要性。此外，未担任临床工作的医院药学人员由于已满足基本的学历要求，且对于成为临床药师的意愿较强，人才来源有保障，加之我国临床药师的培训模式逐渐完善，为我国临床药师培养提供了有利条件，未担任临床工作的医院药学人员成为临床药师具有可行性。结论： 未担任临床工作的医院药学人员成为临床药师具有可行性与必要性，为了促进未担任临床工作的医院药学人员转型成为临床药师，本研究提出了几点建议为政策制定者与医院管理者提供参考。     

Overestimating clinical functions of distributive staff pharmacists.

An unexpected outcome was obtained when an evaluation of the clinical functions performed by distributive staff pharmacists was completed. A random survey of clinical functions was completed by using a pharmacist activity log sheet. Direct observations made by pharmacy administration and information received through discussions with the staff pharmacists, over-estimated the actual amount of time being spent on clinical functions. Use of an integrated approach to pharmacy services requires that enough time for both distributive activities and clinical activities be appropriately balanced to assure effective intervention. PRN clinical pharmacy functions will produce sub-optimal results and negative long-term effects for the profession. Pharmacy administrators must prospectively monitor the clinical activities performed by members of their integrated staff and assure that adequate time is available for effective intervention in the drug use process. Subjective observations and information may not reflect the actual situation and should be considered extremely inaccurate.     

Multidimensional work sampling to study the activities of decentralized clinical pharmacists.

Self-reported multidimensional work sampling (MDWS) was used to study the activities of decentralized clinical pharmacists at six hospitals in Portland, Oregon, and Seattle-Tacoma, Washington, in March through June 1989. A community hospital, a university hospital, and a hospital associated with a health maintenance association were selected in each city, and pharmacists at each site who provided clinical services were recruited. Each pharmacist wore a random reminder device and recorded the activity during which the device sounded by writing on a card numbers assigned to describe work activity, contact, location, and function. Of 6609 classifiable observations, 34.5% (2280) were of clinical activities and 35.8% distributive activities. Pharmacists spent 28.6% of their clinical time reviewing and assessing patients' charts, 17.1% on clinical rounds, 15.9% on activities related to therapeutic drug monitoring, 10.2% providing drug information, 11.6% attending or giving formal education, 6.1% doing research, and 2.6% attending meetings. The average pharmacist spent less than 10 minutes each day with patients but spent a substantial portion of time providing clinical services to other health professionals. Self-reported, multidimensional work sampling appears to be a valuable method for describing and monitoring decentralized pharmacists' work activities at multiple sites and work settings.     

An introduction to the clinical laboratory for pharmacists

The intent of this article is to provide pharmacists with an introduction to the clinical laboratory. As clinical pharmacy services expand, interactions between pharmacists and the laboratory will increase. Laboratory results are an essential tool for pharmacists involved in monitoring drug therapy and adjusting dosing regimens. Laboratory medicine, however, is a complex and rapidly changing field with new analytical techniques and instruments continually being developed. Thus, methodologies vary greatly from one laboratory to another and even within the same laboratory from time to time. Quality control procedures are necessary to ensure accurate and reliable results. The medical technologists who staff clinical laboratories are highly trained professionals. Pharmacists should utilize the medical technologist as a consultant on the interpretation and limitations of laboratory tests. Likewise, there are many areas, such as therapeutic drug monitoring, in which the pharmacist can serve as a consultant to the laboratory. Pharmacists involved in patient care will benefit from a greater understanding of the clinical laboratory, and may also find new opportunities for clinical pharmacy practice and interaction with other health care professionals.     

儿科临床药师的培养

临床药学是医院药学服务的核心,也是医院药学发展的必然趋势.临床药师是随着临床药学发展页产生的现代医院药师的新角色,是现代医院药学实现转型的关键人才.     

药师下临床工作的实践和体会

目的:探讨药师下临床工作的主要内容和进行方式。方法:以笔者临床工作实践和经验为基础,对药师下临床的意义及本院临床药师工作特点进行阐述。结果和结论:药师必须适应医院药学工作的转型,做好临床工作。     

儿科临床药师的实践和体会

儿科病人尤其是新生儿和早产儿，各种生理功能包括自身调节功能尚未充分发育，对药物的反应比较敏感。与成年人有巨大的差别，因而更加需要根据年龄、发育水平、整体健康状况进行合理的个体化药物治疗。临床药学服务的兴起和发展为儿科病人合理用药提供了有益的帮助。我院开展临床药学工作近二年来，逐步摸索，将医院药学与临床紧密结合，积极开展各项药学服务，确保儿科病人用药安全有效，以达到合理用药的目的。     

Contribution of community pharmacists in educating the asthma patients

Background: In asthma, the preventive measures taken by patients play an important role in improving life span and quality of life. This can be done more efficiently by community pharmacist by providing patient counseling and improving knowledge of patient about disease, risk factors, medication management and preventive measures to control asthma. Objectives: The objective of the study was to evaluate the contribution of community pharmacists in improvement of life span and quality of life of asthma patients. Method: The study was performed from Mid September to Mid-November 2014 in Dawadmi, Riyadh province, KSA. Data were collected by using a structured face to face questionnaire with randomly selected different community pharmacies. The questionnaire composed of different closed questions about the action plan of pharmacists in asthma management and factors that affect the counseling of asthma patients by the pharmacists. Results: It is noteworthy to observe that, in general, pharmacists are sufficiently knowledgeable and competent to counsel their asthma patients effectively.     

Managing clinical pharmacists and clinical pharmacy services

One of the ironies in the use of power in today's management setting is that the manager of workers at a high level of readiness is actually giving more power to subordinates as a leadership strategy. Indeed, the empowered manager may achieve goals by shifting responsibility from the manager to the employee, providing a vision for subordinates, providing resources when possible, and providing the freedom to accomplish organizational goals. The challenge for the manager is to determine employee level of readiness and to assess that readiness for different assignments and varying responsibilities. Given the proper situation, the manager may paradoxically gain power (influence over others) by giving others a high degree of responsibility for their actions.     

Ability of clinical pharmacists in a community pharmacy setting to manage anticoagulation therapy.

OBJECTIVES: To determine the ability of community pharmacists within an anticoagulation clinic to keep international normalized ratios (INRs) within therapeutic ranges and, secondarily, to determine the incidence of bleeding and thromboembolic events and patient satisfaction. DESIGN: Retrospective observational study. SETTING: Eckerd PatientCARE Network in Eckerd pharmacies in Tampa Bay area of Florida. PATIENTS: 50 patients taking warfarin and having INR determinations for 6 consecutive months. INTERVENTIONS: Clinical pharmacists monitored patients' anticoagulation status using point-of-care analyzers and making dosage changes as needed under a collaborative agreement. Extensive patient education was provided to patients regarding their anticoagulation. Data were collected from the initial visit through the 6 consecutive months. Patients were surveyed to assess their satisfaction with the clinic. MAIN OUTCOME MEASURES: Percentage of INRs within therapeutic range and, secondarily, incidence of bleeding and thromboembolic events and patient satisfaction with the clinic. RESULTS: During the 6 months of initial therapy with warfarin, 243 of 435 (56%) INRs were in desired therapeutic ranges. A total of 15 bleeding episodes were reported, of which 10 were minor and 5 were significant. No thromboembolic events were reported. There was a 22% response rate to the survey, in which all statements were rated as above average to excellent. CONCLUSION: Community pharmacists in an anticoagulation clinic effectively manage anticoagulation therapy, as the results of this clinic are similar to those of clinics managed by pharmacists in other settings.