我院临床合理用药调查

为规范临床用药，本文对临床药费前10位药品进行了合理用药调查。现报道如下：     

2009年度800份住院病历用药合理性分析

《处方管理办法》中明确要求,药师需要对处方进行用药适宜性审核,处方不仅包括门诊处方还包括病区的用药医嘱。为了提高我院医疗服务质量,了解临床用药情况,笔者抽查了2009年我院的住院病历,对其中用药情况进行了检查、分析、归类和统计,为临床合理用药提供参考。     

借助门急诊病历手册指导老干部合理用药的思考与做法

近年来,我们采取了多种方法提高老干部合理用药水平,其中使用北京地区医疗机构门急诊病历手册,并借助该手册指导老干部用药,收到较好效果。现将我们的思考及做法报告如下。     

坚定不移地抓好临床合理用药工作

1997年5月召开的全军药材工作会议,把以合理用药为主要内容的临床药学工作作为重要议题之一,要求各级卫生行政部门和医院等医疗单位,将其作为卫生部门的一项重要工作来抓。经过一年多各级领导及医疗单位广大医药等工作者的努力,已取得显著成绩。各卫生行政部门加大了对此项工作的领导力度,定期组织举办学习班、专题讲座和学术会议;基础好的几所总医院,在临床药学工作原有基础上继续扎实工作,不断拓宽工作范围,提高工作质量,并保持了各自的工作专长与特色,在合理用药计算机管理咨询、血药浓度监测、药代动力学研究、药师下临床参与抢救病人和治疗方案制订、全军药物不良反应监测网(站)的建立和运行、临床药学信息工作等方面,均取得了明显成效;其它多数医院和基层医疗单位,临床药学工作也在不断深入和发展,合理用药意识在全军医务工作者和部队伤病员中不断增强,全军临床药学工作已呈现出良好势头。但要进一步把此项工作推向深入,以适应部队官兵健康和国家经济建设的需要,面临的形势仍较严峻,任务还很艰巨。为坚定不移地抓好我军临床药学工作,本期我部编辑了临床药学专期。今后,亦欢迎机关领导和广大医药卫生工作者继续勇跃投稿,以指导和促进此项工作向纵深发展,不断提高部队医疗质量和部队官兵健康水平,为     

部队合理用药系列讲座（6） 急性胰腺炎临床合理用药

1用药原则1.1用药目的发病初期的用药是为了纠正水、电解质紊乱,支持治疗,抑制胰液分泌,防止局部及全身并发症。     

部队合理用药系列讲座（8） 急性心肌梗死临床合理用药

1用药原则 1.1用药目的 对心电图ST段抬高的急性心肌梗死（AMI）,强调早发现、早住院,并加强住院前救治,尽快恢复心肌的血流灌注,以挽救濒死的心肌,防止梗死扩大,缩小心肌缺血范围。及时处理严重心律失常和并发症,保护和维持心脏功能。     

临床合理用药系列讲座(2)冠心病药物临床合理应用

冠心病是冠状动脉粥样硬化性心脏病的简称.不同类型冠心病,用药也不相同.因此,根据冠心病患者的个体情况,临床选择合适的药物非常重要.     

临床合理用药系列讲座(3)抗心律失常药物临床合理应用

当前,心律失常药物治疗的关键,是针对不同的疾病或状态,合理选用药物,尽可能发挥其治疗效能,降低不良反应.     

临床合理用药系列讲座(1)抗高血压药物临床合理应用

高血压病是以血压升高为主要临床表现的综合征.一旦发病,一般须终生服药.因此,根据高血压病患者的个体情况,合理选择合适的药物非常重要.     

利用合理用药软件系统对医院用药情况进行评价

目的 :研究医院合理用药软件系统并对医生合理用药进行评价。方法 :(1)利用PASS系统对医嘱进行合理用药分析 ;(2 )通过Office 2 0 0 0中的MicrosoftExcel将系统的监测结果分类统计 ;(3)通过病案实际调查得出结论。结论 :住院病人医疗用药情况基本正常 ,但还存在不足 ;PASS系统十分符合临床医生的需要 ,但仍存在一些缺陷。     

疗养院重点护理记录单的设置与应用

病历书写规范要求：护理记录分为一般患者护理记录和危重患者护理记录。疗养院由于服务对象与医院不同,若也如此区分存在较大局限性。近年来,我院根据疗养院实际,采取划分重点护理对象,建立重点护理记录单方法,通过临床实践,不仅有效提升了护理质量和管理水平,也弥补了原来交班报告未入档不具法律文书效力的缺陷,取得较满意效果。现将我院重点护理记录单的设置与应用情况介绍如下。     

Should a patient have access to his medical records

An investigation is undertaken into the right of a patient to have access to medical records concerning himself, and the ownership of medical records and X-ray photographs is discussed. It is argued that record accessibility by patients is to favoured. The current situation in England and the United States of America is considered and proposals de lege ferenda are made with respect to South Africa. The author is of the opinion that the South African legislature should consider legislation in this regard.     

老年葡萄球菌感染肺炎去甲万古霉素治疗的血药浓度监测及意义

目的分析与探讨老年葡萄球菌感染肺炎应用去甲万古霉素后血药浓度监测指导临床合理用药的价值。方法选取我院收治的葡萄球菌肺炎80例,根据年龄将其分为2组,老年组50例,中青年组30例。给予去甲万古霉素进行静脉滴注,治疗3 d后对其血药浓度进行监测,并根据监测结果调整给药方式与给药剂量以指导临床合理用药。比较调整前后血肌酐水平与血尿素氮水平。结果老年组应用去甲万古霉素后的血药浓度变化与中青年组相比差异有统计学意义(P<0.05)。调整给药方式与给药剂量后,血肌酐与血尿氮素水平均趋于稳定。结论老年患者使用去甲万古霉素进行治疗过程中监测血药浓度能够有效指导合理用药,降低药物损害。     

肝功能异常患者合理用药系统的构建与应用

目的 构建肝功能异常患者合理用药系统,快速及时给予用药提示。方法 利用SPRING的三层C/S架构建立肝功能异常患者合理用药系统,通过统计2021-01至2021-08肝功能异常患者用药信息来评价该系统的使用效果。结果 2021年1-8月,系统提示合理用药建议1562条,医师接受警示数1138条,占72.85%,肝功能异常患者的合理用药率逐月提高,2021年8月达到了77%,较1月(58%)有显著提高。结论 肝功能异常患者合理用药系统能根据患者的肝功能及时给予用药提示并快捷优化医师用药剂量的选择,实现了科学合理用药。     

某三级甲等医院医务人员锐器伤发生情况调查

 目的 了解某三级甲等医院医务人员锐器伤发生情况,发现危险因素,提出预防与控制措施,降低锐器伤发生率。方法 采用问卷调查法,对某三级甲等医院2017-04医务人员发生锐器伤情况进行回顾性调查。结果 在调查的1184名医务人员中,发生锐器伤19人,锐器伤发生率为1.60%。不同工作类别医务人员发生锐器伤差异有统计学意义,护士锐器伤发生率高于医技人员;不同性别、工作年限医务人员发生锐器伤差异无统计学意义。锐器伤高发科室为普通病房,占78.95%;高发操作环节为静脉/皮下注射,占36.84%;高发器具为一次性注射器,占36.84%。结论 2017-04某医院锐器伤发生人群集中在护士,发生场所集中在普通病房,发生时机集中在静脉/皮下注射,发生器具集中在一次性注射器,应加强对高危人群、高发环节的监管,规范操作,降低锐器伤发生率。     

Paperless medical records: moving from plan to reality

In 2002, North Shore Magnetic Imaging Center (NSMIC) decided that a major restructuring of the patient process was necessary to alleviate staff frustration and increase the level of patient care. An aggressive, 16-month timeline was established for the center to develop and implement a paperless environment. The project began by focusing on the center's existing radiology information system (RIS). Research showed that no "canned" system would perform the necessary tasks. The center's vendor, with whom senior management had developed a longstanding and trusting relationship, assured the center that, with the proper programming, the existing RIS could support the new paperless environment. Additional technology components were addressed. The first phase enabled staff to obtain physician orders and outside reports from the fax server. Once the patient medical record was fully electronic, these external documents were no longer printed. The transfer of billing information to the radiologist's billing office was achieved through a Health-Level 7 (HL7) interface between NSMIC's RIS and the information systems utilized by the billing office. Technologists were impacted when wireless personal computer (PC) tablets were implemented. Measuring 8.5" x 11" x 0.5", these tablets enable technologists to gather and record patient information while moving freely throughout the center. Forming the Reinvention Team--an internal team of NSMIC staff that would deal with the project's impact on staff, workflow, and patient care--was done in very deliberate fashion. During the recruitment phase of the project, each prospective team member was required to take 2 specific personality profile tests. The team was comprised of a combination of different personality profiles. A radiologist was later added to the team. Throughout the implementation of new processes at NSMIC, numerous breakdowns were encountered. The breakdowns could be classified into 2 categories: technical andpatient-related. Breakdowns were addressed during the Reinvention Team's weekly meetings. A patient's experience at NSMIC has changed dramatically with the implementation of electronic medical records. More patients are able to complete their exam without experiencing anxiety, or even at time claustrophobia, because they are more at ease. The rate for patients becoming claustrophobic has seen a decrease from 1.9% to 0.99% in the past 12 months.