西安市医疗机构临床药学工作开展现状调查

目的：调查西安市医疗机构临床药学工作开展状况,以促进临床药学工作的进一步发展。方法：分级分类抽取西安市24家二级以上医疗机构,对其临床药师现场进行问卷调查,内容包括医院基本信息、临床药师的基本情况、临床药学工作开展状况。结果：被调研医疗机构全职临床药师占60.2%,平均每位临床药师服务床位数为133.1±53.8（床/人）。各医疗机构中主要开展的临床药学工作有用药干预（95.8%）、药学咨询（91.7%）、细菌耐药监测（41.7%）、治疗药物监测（20.8%）。临床药师进行了查房（96.6%）、药品不良反应监测（95.8%）、合理用药培训（84.8%）、患者用药教育（80.5%）、重点患者药学监护（78.0%）、特殊管理药品药学监护（47.5%）、实习生和进修人员培训（61.9%）、疑难危重患者会诊（56.8%）、科研工作（42.4%）等临床药学工作。每天药学服务时间多为1~2 h（68.6%的临床药师）。三级医院、二级医院每日查房频次大于等于一次的分别为34.1%,3.5%。参与会诊的临床药师有67.1%认为"医师会参考临床药师提供的用药信息"。3.4%的临床药师认为"ADR监测工作开展很好且临床很支持"。三级医院临床药师更重视查房、ADR监测和科研工作（P<0.05）,二级医院临床药师与护士沟通较多（P<0.05）。结论：西安市各级医疗机构临床药学工作已经普遍开展,但开展情况有差异,三级医院查房频次、ADR监测和科研工作重视程度较高,二级医院与护士沟通较多。

Investigation on development of clinical pharmaceutical care of medical institutions in Xi'an

OBJECTIVE To survey the status of clinical pharmaceutical care in medical institutions of Xi'an city, and promote its progression in the future.METHODS Questionnaires had been adopted in this study. The information was extracted from 24 hospitals based on their different grades. The present survey questionnaires included essential information of hospitals, clinical pharmacists, and the condition of clinical pharmaceutical care.RESULTS The full time clinical pharmacists accounted for 60.2% in the questioned population. The average bed number served by each pharmacist was 133.1±53.8 (bed/person). The percentages of medical institutions for carrying out irregular drug interventions, outpatient pharmacy counseling, monitoring analysis of drug-resistant bacteria, therapeutic drug monitoring (TDM) were 95.8%, 91.7%, 41.7% and 20.8%, respectively. The development of inspection, adverse drug reactions (ADR) monitoring, training for rational use of drugs, patient medication education, pharmaceutical care of special patients, pharmaceutical care for management of special drugs, training for interns and refreshers, consultation for critical and complicated patients and pharmaceutical research accounted for 96.6%, 95.8%, 84.8%, 80.5%, 78.0%, 47.5%, 61.9%, 56.8%, 42.4%, respectively for the clinical pharmacists. The time of pharmaceutical service was generally 1-2 h in a day (accounted for 68.6%). The frequency of ward round for clinical pharmacists was less than one time a day, accounting for 34.1% in the tertiary hospitals and 3.5% in the secondary hospitals. The percentage of clinical pharmacists who believed "doctors would accept suggestions of clinical pharmacists" was 67.1%. The percentage of clinical pharmacists who considered "the ADR work was well done, and supported by the clinical staff" was 3.4%. Compared to the secondary hospitals, the clinical pharmacists of tertiary hospitals paid more attention to ward round, ADR monitoring and pharmaceutical research (P<0.05). Compared to the tertiary hospitals, the clinical pharmacists of secondary hospitals more frequently communicated with the nurses (P<0.05).CONCLUSION The clinical pharmaceutical care has been widely developed in medical institutions of Xi'an city, but there are remarkable differences among different hospitals. The clinical pharmacists of the tertiary hospitals pay more attention to ward round, ADR monitoring and pharmaceutical research, while those of secondary hospitals more frequently communicate with the nurses on rational use of drugs.