The clinical pharmacist makes pilot project to crave for " The motive force "
Staff reporter's yellow Wei's grandson's dream The pilot project was hit " Qianfo Mount " The sample is in Ministry of Public Health cures the clinical pharmacist that drugmaker of policy department's hosting, favor supports and makes the field experience exchanging meeting of pilot work recently, it is exciting that the Qianfo Mount director in Shandong attacks a group of data that the swallow provides: Pass the efforts of the clinical pharmacist, the correct rate of utilization of 4 kinds of antibacterial medicines such as his pyridine of parenteral very beginning spore a amine sodium, parenteral very beginning spore of this institute, 100% rising to 2008 from 48%~63% in 2007 separately. Though this is only a individual case, prove the clinical pharmacist's function begins to appear progressively. The doctor " should say on the initial stage of launching a pilot project, the clinical department still holds the attitude of a kind of query to launch this job from querying to accepting. Implement after the one year, a lot of clinician show clinical pharmacist offer much to doctor use medicine consultation at forum, have avoided a lot of medicine bad reactions effectively, and provide the suggestion in using medicine of difficult case, a large amount of time saving the nurse at the same time. " Attack swallow, say practice show, clinical pharmacist make, work, ensure the intersection of patient and the intersection of administration and security, improve doctor use medicine rationally respect one benign motive force really. A lot of institute this launch a pilot project clinical department require clinical pharmacist get the intersection of they and department go on, use medicine knowledge lecture voluntarily nowadays, and participate in department's holding a consultation. While the medicine bad reaction takes place, through requiring the clinical pharmacist to participate in solving actively such as ENT dept. of this institute, have avoided several disputes. Qianfo Mount hospital ICU director Jie Jian says, through the work of the clinical pharmacist, makes the rational administration more normal. The men 30 year old of 70 kilograms such as a weight and a woman 70 year old of 70 kilograms in weight, skin anhydride value of serum is 160umol/l, but removing rate of anhydride of their skin is 64.5ml/min and 31.8ml/min respectively, as to most medicines, the former does not need to adjust the dosage, but the latter needs decrement to be even unsuitable to use. The clinical pharmacist will direct against the function of important internal organs such as each patient's liver, kidney,etc., assist the doctor to choose to use medicine and adjust the dosage at any time according to the condition change, guarantee a patient uses medicine safely. It is reported that the management mode begins to be clear, the hospital where progress for pilot work is comparatively smooth, the thinking of management of the clinical pharmacist is clear progressively, have defined the clinical pharmacist makes a reservation and participates in clinical drug therapy working content and method, have confirmed clinical pharmacist's duty, professional technique basic demand and work pattern, set up clinical pharmacist's performance evaluation examination method at the same time. Qianfo Mount hospital has aroused the attention from everybody to the clinical pharmacist's method to implement the double management mode. "Say from the aspect of the hospital, the clinical pharmacist makes the support which needs the administration and supervision authorities of the hospital, the participation of the medical matters department, but not merely pharmacy department and work of clinical pharmacist. " Attack swallows, say, behind confirming this thinking, the hospital defines medical matters department is managed as synthesizing and coordinating the department, the department of the Chinese Academy of Sciences of medicine offers technical support, the clinical department participates in actively. The clinical pharmacist is managed doubly by the department of the Chinese Academy of Sciences of medicine and pilot department where one stays, the year-end examination of the clinical pharmacist is organized by department of the Chinese Academy of Sciences of medicine, listen to the appraisal of the clinical pilot department while examining. With the deepening that the clinical pharmacist worked, this institute is exploring the new job " focus " constantly too . Head of the department Li Yan of tumour says, directs against the clinical focal point of work of oncology department, such as compatibility, cancer of chemotherapy medicine and other medicines ache medicine management, nutrition support the application of medicine etc., they have also made the next clinical pharmacist's work program in subject. Among them the first plan is for the cancer pain patient, are graded pain by the doctor, the pharmacist chooses the pain medicine ' Such as taking orally or for external use) , the medicine dosage chooses, breaks out the pain medicine to choose. After clinical use, the doctor makes curative effect to assess. Another plan is for the palliative treatment patient, are confirmed patient's daily necessary infusion amount, heat and electrolyte by the doctor, the pharmacist makes the concrete liquid kind through calculating ' For instance glucose, physiological saline, fat milk, amino acid, albumin,etc.) , dosage, and electrolytic ' Potassium, sodium, chlorine, calcium,etc.) Consumption. The reporter observes the problem to be solved and makes the pilot hospital to supervise and guide 20 clinical pharmacists of 8 provinces and cities such as Jiangsu, Shanghai,etc. recently in many Ministry of Public Health, the result reveals, the clinical pharmacist has made pilot work and has been approved by the pilot hospital. Some hospital set up led by institute leader generally, the intersection of medical matters and, clinical department, the intersection of pharmacy and pilot group that department participated in directly. Some hospital leaders participate in making the work program in person, and propagate the meaning of the pilot project at the whole institute's meeting many times, and solve the problem that met in the pilot project actively. Most hospitals select the pilot department conscientiously, and adopt various systems to ensure the management of the clinical pharmacist, have achieved better result. "The directors of the clinical departments of some hospitals participate in pilot work actively, have brought along the clinician to make the approval that pilot work and clinical pharmacist work to the clinical pharmacist. In some pilot hospitals, fully communicating will play very good guarantee function on the development which the clinical pharmacist made pilot work. " An expert participating in supervising and guiding says. However, supervise and guide the result this time to reveal, it is unbalanced that the pilot project is promoted. In advance work that clinical pharmacist make while being solid, have some hospital carry on deep push some hospital, 1/3 of the hospitals have not moved so far. A great deal of problems need to solve some institute leaders and know nothing about pilot project and supervise and guide finding, the depth that the clinical pharmacist who some pilot hospitals make participates in the management system of clinical application, characteristic obvious enough, especially lack the clinical pharmacist and participate in the system regulation that the concrete operation of the work of clinical application implements the respect. It is not enough also some leaders of hospital pay attention to, the attitude to pilot work of medical matters department is not positive enough, some the intersection of hospital and leader even clear clinical pharmacist make pilot project what is it about, some hospitals have obscured the concept of clinical pharmacist and clinical pharmacy, the deviation realized. Still find while supervising and guiding, set up in some hospitals to hold a part-time job the clinical pharmacist, these questions cause some hospitals to fail to form clinical pharmacist's clear thinking of making construction so far directly. The clinical pharmacist still trains the hospital where there is the deficiency though the work of the clinical pharmacist is quite enthusiastic, it is not enough but because train, lead to the fact clinical pharmacist's clinical application knowledge is insufficient. In addition, it is not enough for some provincial health authorities to supervise and guide and check, in the province that is already supervised and guided, have not made pilot work and assigned, checked and supervised and guided to the clinical pharmacist of the pilot hospital of this area in some provinces. Make suggestions and give advice, aspire for development, direct to be solved problem against, conferee to how the intersection of norm and clinical pharmacist work, strengthen medicine protect communicate, clinical people of pharmacist Cost of strength and strengthening and training etc. and making suggestions and giving advice to the clinical pharmacist actively. Can set up second department Qianfo Mount hospital heart head of the department of internal medicine Xing QiChong to think, clinical the intersection of pharmacist and work position should set second discipline as, set tertiary discipline can lead to the fact speciality narrow. He hope clinical pharmacist work institutionalized, standardization in clinical medical treatment, make them become workers on the permanent staff of clinical department. Entry system want, improve a pilot hospital of persons in charge, propose clinical pharmacist work, take, set up long-efficiency mechanism, also need support of the national relevant policy. For example in the clinical pharmacist's entry when the system is set up, should set up and improve compensation and incentive mechanism in conformity with it first, improve the hospital and launch the clinical pharmacist's enthusiasm of making work. Secondly, need to set up the incentive mechanism directed against the clinical pharmacist too, can reflect its value rationally, for example consult a doctor and consult about the standard, collect the corresponding consultation fee. "The hospital like such scale, there are 5 clinical pharmacists, are far from meeting the demand. " Attack swallows and say. She says, will popularize the clinical pharmacist's system on a large scale in the future at the same time, will certainly have related mechanism construction soon, the hospital should consider after all could fill the cost of manpower and operate the question that the expenses rise after increasing. " Some hygiene administrative department heads propose strengthening the cultivation of the clinical pharmacist to devote more efforts to training, promote safe reasonable administration work really. Propose bringing the clinical pharmacist's work into corresponding medical treatment system at the same time, if join the corresponding content in the key system, define the clinical pharmacist's duty, authority. Propose participating in the clinical pharmacist some clinical document materials, list in " basic norm of the clinical case history ", and regard it as the subjective case history materials category. Ministry of Public Health cures the relevant persons in charge of policy department to propose, the health authorities at all levels should explore actively the clinical pharmacist make the mode, put forward the suggestions actively. The pilot medical organization should implement positively conscientiously, strengthen the training of the clinical pharmacist, select the potential and clinical pharmacist of ability. Strengthen the propaganda making the work to the clinical pharmacist, promote the development of this job. He says, the human resources of medical organization are insufficient,etc. can't launch the clinical pharmacist and make work without representing, the more important thing is some medical organizations lack the motive force. It is not a time question that the clinical pharmacist makes and popularizes in the whole country in an all-round way, it is a motive force question.
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