(1) prescription review
1, outpatient prescription review
(1) According to [2020] No.21Hospital Prescription Review System, randomly select 100 outpatient prescriptions for review every month, and review 1200 prescriptions within one year * * *, analyze and summarize the review situation, and report unreasonable prescriptions and doctors to the whole hospital.
(2) Collect all unreasonable outpatient prescriptions within a week every month, make statistical analysis according to departments, sort out the problems existing in prescriptions, and feed them back to clinical departments in the form of rectification notices, requiring all clinical departments to take corresponding rectification measures according to the existing problems.
2, outpatient antimicrobial prescription comments
Review the prescriptions of 25% doctors who have the right to prescribe antibacterial drugs every month, with no less than 50 prescriptions for each doctor and no more than 50 opinions. * * * Reviewed 66 12 prescriptions of antibacterial drugs throughout the year, analyzed and summarized the review results, and sorted them according to the results of outpatient prescriptions of antibacterial drugs, excluding 10 doctors before rational use of antibacterial drugs and 10 doctors before unreasonable use of antibacterial drugs.
(2) Review of surgical medical records
Every month, a certain number of surgical records of various surgical departments are selected for comments, and the rationality of preventive use of antibiotics during perioperative period is commented. The main points of the opinion are whether there are indications of preventive medication, the time of preventive medication, the variety of preventive medication and whether the course of preventive medication is reasonable. A total of 465 surgical records were reviewed throughout the year.
(three) to complete the statistics of the basic situation of clinical application of drugs every month.
1. Dynamic monitoring of drug use: drugs in outpatient department, inpatient department and hospital every month 10;
2, outpatient antimicrobial prescription ratio, emergency antimicrobial prescription ratio;
3. Utilization rate of antibiotics for outpatient doctors;
4. Utilization rate and intensity of antibacterial drugs in clinical departments;
5. The detection rate of microorganisms using antibacterial drugs, the detection rate of microorganisms using restricted antibacterial drugs and the detection rate of microorganisms using special antibacterial drugs in clinical departments.
(4) Reporting and monitoring of adverse reactions
1, formulated the Implementation Measures for the Management of Adverse Drug Reactions Reporting and Monitoring in Hospitals, trained doctors and nurses in adverse drug reactions reporting and monitoring in our hospital, made statistical analysis on adverse drug reactions reports in our hospital every six months, and reported them to the whole hospital in the form of documents. In 20xx, 94 cases of adverse drug reactions were collected and reported, and the number of tasks assigned to our hospital by the US Food and Drug Administration was completed.
2. Investigate the adverse drug reactions/incidents in clinical departments in time, analyze the causes of adverse drug reactions, and upload the specific information and precautions of drug use in clinical departments to OA system in the form of drug news for clinical departments' reference. 20xx * * * wrote six medical news articles.
(5) Participate in clinical practice.
Clinical pharmacists attend rounds in general surgery, oncology hematology and clinicians from time to time.
(6) Writing "Clinical Drug News"
Write quarterly 1 issue of clinical drug news, including relevant policies and regulations, hospital drug use information, national adverse drug reactions notification, rational drug use, etc.
(7) information submission.
Submit the usage of antibacterial drugs in our hospital to Chongqing Pharmaceutical Administration Quality Control Center every quarter.
(eight) to participate in drug quality control.
Participate in the quality inspection of standing drugs and refined narcotic drugs in pharmacy and clinical departments every month, mainly to check whether there are expired drugs, the storage of drugs, and all links of refined narcotic drugs from prescription by doctors to registration of patients after use.
Second, the shortcomings in clinical pharmacy:
Although clinical pharmacy has made some achievements and progress, it is still in the primary stage, and many projects have not yet been put into operation, which is still far from the evaluation requirements of tertiary hospitals. Specific performance in:
(a) found the problem, formulated the system, but not implemented.
In the statistical analysis of the above prescription comments and surgical records comments, we found out what irrational drugs were used in our hospital, especially the irrational use of antibacterial drugs. The hospital has also formulated "Detailed Rules for the Management of Clinical Application of Antibacterials in Hospitals" and other systems to regulate rational drug use, but failed to supervise and rectify according to regulations. Therefore, we need the support of medical department, quality control department and other executive departments to strengthen the cooperation between various departments.
(2) Insufficient clinical participation.
At present, only pharmacy rounds are conducted. Because the clinical pharmacists are still young, they have not participated in clinical practice such as case discussion and hospital consultation of difficult and serious cases. It is hoped that the leaders of the hospital will provide clinical pharmacists with learning opportunities (participating in various consultations and other activities in the hospital for free; Opportunities to study abroad, etc. ).
(3) The work content is various and the efficiency is not high.
At present, the function of information software is not perfect, many tasks need manual statistical analysis, and each task is time-consuming, which leads to the lack of professional quality of clinical pharmacy. Therefore, it is hoped that the hospital can purchase clinical rational drug use software separately, improve work efficiency, and let clinical pharmacists have enough energy to participate in clinical practice. Take patients as the center and rational drug use as the core to carry out real clinical pharmacy work.
III. 202 1 Work Plan of Clinical Pharmacy
According to the requirements of Detailed Rules for the Evaluation of Grade III and Grade A Hospitals, 20xx National Special Remediation Plan for Clinical Application of Antibacterials, Regulations on Pharmaceutical Affairs in Medical Institutions, Prescription Management Measures, etc., while completing the above work, the following work needs to be done:
(a) to strengthen the training of doctors and nurses in our hospital antibacterial drugs, continue to implement the relevant provisions of the clinical application of antibacterial drugs, and strive to control the indicators of antibacterial drugs within the scope, and strengthen the management of rational use of antibacterial drugs in Class I incision surgery.
(two) improve and implement the relevant system of rational drug use.
(three) to participate in clinical practice:
1, strengthen pharmaceutical rounds, carry out pharmaceutical care for key patients and establish a pharmaceutical calendar with relevant work records;
2. Participate in case discussion, and put forward medication suggestions and treatment suggestions;
3. Participate in the difficult and severe consultation in the hospital;
4. Intervene in clinical irrational drug use and record it;
5. Provide training and consulting services for clinicians and nurses on rational drug use on a regular basis, and keep records.
(four) to carry out drug counseling services: to educate patients on drug use, guide the safe use of drugs, and record.
(5) Establish a clinical pharmacist system and initially carry out the work of clinical pharmacists. At the beginning of 2020, 1-2 people were sent to a higher hospital for short-term study or sent to a clinical pharmacist training base for training. After obtaining the qualification, the clinical pharmacy work in our hospital will be strengthened.
Summary and Plan of Clinical Pharmacy Work 2 With the great attention of hospital leaders and the strong support of clinical departments, the clinical pharmacy room has successfully completed all the tasks formulated at the beginning of the year through the unremitting efforts of clinical pharmacists. The main achievements, shortcomings and next year's work plan are reported to the hospital leaders as follows.
First, the work system and annual work objectives have been formulated.
At the beginning of the year, the responsibilities and system of clinical pharmacy room in xxxx hospital were formulated and bound into a book. At the same time, the 20xx annual work plan and work target are formulated, and the monthly work summary is implemented. Make its work institutionalized, its operation streamlined and its responsibilities clear.
Second, insist on the institutionalization of clinical departments
Adhere to the institutionalization of clinical department services and provide medication consultation for doctors, nurses and patients. The system of daily shift rounds in clinical departments, weekly rounds in hospital departments, monthly prescription reviews and drug analysis, and quarterly clinical drug news editing and publishing. So that all work can be programmed, organized and institutionalized.
The third is to carry out monitoring of adverse drug reactions.
At the beginning of the year, the leading group for ADR monitoring was adjusted, and the management rules for ADR monitoring for 20xx years were formulated. The adverse drug reaction information of the National Adverse Drug Reaction Center shall be notified in a timely manner in the form of drug news every quarter. In July, Wang Zhi, director of ADR monitoring center, was invited to give a lecture on ADR monitoring in our hospital, which achieved good clinical results. The clinical pharmacy department reported 50 cases of adverse drug reactions to the National Center for Adverse Drug Reactions, including 4 cases of serious adverse reactions and 7 cases of new adverse reactions. The monitoring of adverse drug reactions in our hospital was not only successfully completed in quantity, but also improved in the quality of reports, which was well received by the leaders of the US Food and Drug Administration. At the same time, the plan for handling serious adverse drug reactions in our hospital was formulated, and the serious adverse drug reactions in our hospital were promptly warned and analyzed. Remind the medical staff to strictly grasp the indications, and inform all clinical departments that skin tests should be done before using low molecular dextran, and at the same time avoid using it with traditional Chinese medicine injections such as compound Danshen, and strengthen monitoring when using it to prevent serious adverse reactions from happening again.
Fourth, do a good job in hospital rounds.
In 20xx, through clinical departments, the irrational drug use of key, critical and difficult patients in our department was reviewed, and the existing problems and improvement measures were analyzed and pointed out. Individual controversial issues should be communicated privately with department directors and clinicians to reach a consensus, mutual understanding, mutual promotion and common development. Over the past year, I have written rounds of internal medicine, internal medicine, oncology, general surgery, orthopedics, acupuncture, obstetrics and gynecology, and anorectum, and distributed them to various clinical departments in the form of drug news.
Five, strengthen prescription review and punishment for unreasonable drug use.
The clinical pharmacy room randomly checks 30 inpatient medical records, 600 outpatient prescriptions and 600 inpatient prescriptions every month, and makes prescription comments and irrational drug use analysis on our hospital's doctor's orders and prescriptions once a month, and sends them to all clinical departments in the form of drug news. At the same time, the prescription review system of xxxx hospital and the management regulations of clinical rational drug use in xxxx hospital were formulated. At the weekly meeting of the hospital, the phenomena such as incorrect prescription writing, drug incompatibility, drug overdose, drug use without indications, unreasonable use of antibacterial drugs were reported, and certain economic penalties were given, and individuals were punished. It aims to ensure the quality and safety of medical treatment, improve clinical efficacy and promote rational and standardized drug use.
Six, to carry out special drug analysis
In view of the irregular clinical drug use in different periods, departments and departments, the clinical pharmacy room has carried out special and specialized drug use analysis for key outstanding problems. 20xx 1 February, 20xx March, 20xx April, 20xx May and June, 20xx May and June. In July, the incompatibility and unreasonable combination of commonly used drugs in clinic were analyzed. In August, the common irrational drug use in the Department of Gastroenterology was analyzed again. In September, the drug treatment of chronic heart failure in our hospital was investigated and analyzed. 65438+ 10 June, how to choose Chinese medicine to treat influenza was done. In June, 165438+ 10, I wrote my own experience about paying attention to the use of drugs for cor pulmonale, and in February, how to treat gout patients. Above, from the clinical outstanding problems, specialist medication problems, medication details, in the form of prescription case analysis. It was analyzed in detail from the aspects of drug treatment guidelines, pharmacodynamics, pharmacokinetics, drug interaction and adverse drug reactions, which greatly promoted and standardized clinical rational drug use and was well received by clinicians.
Seven, strive to create and create an academic atmosphere.
The clinical pharmacy room has always paid attention to strengthening the cultivation and improvement of professional quality, humbly learning from old experts and professors, assiduously studying business, striving to create and create an academic atmosphere, and creating a learning department. As the editor-in-chief, he compiled a textbook of Clinical Pharmacology with more than 280,000 words, which was published by Tianjin Sci-tech Translation Publishing House in August. In the whole year, he published 8 papers in China Pharmacovigilance, Licensed Pharmacists in China and Community Physicians in China, and published 5 professional articles/kloc-0 in the column of pharmacists talking about drugs in China Medical News, a national professional newspaper.
Eight. Existing problems and deficiencies
Although clinical pharmacy has made some achievements and progress, it is still in the primary stage, and many projects have not yet been put into operation, which is far from the advanced level of the whole province and the whole country. Specific performance in:
(1), the working mode of clinical pharmacy is still being explored and explored. All work needs to be further standardized and concretized, and the clinical pharmacist system needs to be further improved.
(2) The knowledge level of clinical pharmacists is limited, lacking clinical practical experience and ability, and the level of participating in clinical rational drug use needs to be further improved.
(3) There is a shortage of clinical pharmacy talents, so hospitals should strengthen the introduction of talents in this field and increase the training and continuing education of clinical pharmacy personnel.
(4) The basic construction of reference room and instrument room in clinical pharmacy room needs to be solved by the hospital.
Nine. 20xx work plan
(1), speed up the construction of clinical pharmacy team.
According to the post allocation requirements of clinical pharmacy of the Ministry of Health, there are at least 3 full-time clinical pharmacists in the second-class hospitals and at least 5 full-time clinical pharmacists in the third-class hospitals. At present, there is only one person participating in our hospital, which is extremely disproportionate to the scale and business development of the hospital. This requires the hospital to strengthen the introduction of clinical pharmacy talents next year, increase the number of clinical pharmacy undergraduates 1 person and graduate students 1 person, and further enrich and strengthen the construction of clinical pharmacy team.
(2) Strengthen the quality education of clinical pharmacy.
Clinical pharmacy is a highly professional pharmaceutical practice closely combined with clinical practice. It is required that every clinical pharmacist must have a solid knowledge of pharmaceutical concepts, and at the same time, he must have rich clinical practice experience and master the latest progress of clinical drug treatment. Strengthening the study of clinical professional knowledge and going deep into wards to participate in ward rounds and consultations are the focus of next year's work. At the same time, hospitals and departments should attach importance to and increase on-the-job training and continuing education for clinical pharmacy personnel, emphasize the cultivation of clinical practical skills and the establishment of clinical thinking and clinical path, and strive to build and build a learning department in hospitals.
(3) Improve the basic construction of clinical pharmacy.
Clinical pharmacy reference room and instrument room are the most basic infrastructure of clinical pharmacy. Invest in the necessary reference books, reference books, periodicals, instruments and equipment in the clinical pharmacy room, strive for the support and investment of the hospital next year, and improve the basic construction of clinical pharmacy as soon as possible.
(4) Participate in the monitoring of rational drug use.
In 20xx, the Ministry of Health asked secondary hospitals to participate in national rational drug use monitoring and become network hospitals. This requires the pharmacy department and the hospital information center to make preparations as soon as possible, actively cooperate and pay attention to efficiency, so that the network report work of our hospital can be realized smoothly as soon as possible.
(5) Efforts should be made to promote the informatization construction of clinical pharmacy.
The informatization construction of clinical pharmacy is an important part of hospital informatization construction. It is the need of the development of modern hospitals to install rational drug use software and establish clinical pharmacy workstations. It needs hospital support and increase investment in this area. Strive to complete the informatization construction of clinical pharmacy as soon as possible, so that the clinical pharmacy work will continue to develop and strengthen, and better serve the clinic and patients.
The above is my report. Please criticize and correct my mistakes.