全程化药学服务在我院日间化疗中心的应用
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篇名: 全程化药学服务在我院日间化疗中心的应用
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摘要: 目的:为提高医疗资源利用率、患者化疗依从性和合理用药水平提供参考。方法:介绍我院日间化疗中心工作模式和全程化药学服务模式,并总结全程化药学服务在我院日间化疗中心的实施效果。结果:临床药师作为日间化疗多学科协作工作组的核心团队成员之一,参与筛选化疗方案、制定临床路径、制定日间化疗患者纳入标准、参与信息化管理等日间化疗中心部分工作。在临床药师、审方药师和调剂药师的介入下,依托静脉用药调配中心(PIVAS)为患者提供全程化药学服务,包括以预审方与实时审方相结合的方式审核化疗用药医嘱、规范化调配化疗用药、借助闭环管理信息系统在后台实时监控用药全过程、主动提供药学监护服务和用药宣教等。全程化药学服务模式能有效减少不合理用药,我院化疗输液在预处理、水化、给药顺序、冲管、放置时间、滴速这6个方面的合格率由全程化药学服务实施前(2017年5-7月)的76%、50%、94%、50%、54%、54%分别提高至全程化药学服务实施后(2017年9-11月)的100%、100%、100%、100%、94%、96%。结论:在日间化疗中心开展全程化药学服务,可提高医疗资源利用率、患者化疗依从性和合理用药水平。
ABSTRACT: OBJECTIVE: To provide reference for improving the utilization rate of medical resources, the compliance of patients with chemotherapy and the rational use of drugs. METHODS: The working model of day-time chemtherapy center and the model of full-course pharmaceutical care were introduced in our hospital. The effects of full-course pharmaceutical care were summarized. RESULTS: As one of the core team members of the multidisciplinary collaborative working group on day-time chemotherapy, clinical pharmacists participated in the selection of chemotherapy schemes, the formulation of clinical pathways, the formulation of inclusion criteria for patients undergoing day-time chemotherapy, and the participation in information management of day-time chemotherapy centers. With the intervention of clinical pharmacists, prescription pharmacists and dispensing pharmacists, the patients were provided with full-course pharmaceutical care relying on pharmacy intravenous admixture service (PIVAS), including the combination of pre-reviewing and real-time reviewing to examine and verify the medical orders for chemotherapeutic drugs, standardizing deployment of PIVAS chemotherapeutic drugs, real-time monitoring of the whole process of drug use in the background with the help of closed-loop management information system, actively providing pharmaceutical care, medication education and so on. The full-course pharmaceutical care model could effectively reduce irrational drug use. The qualified rates of chemotherapy pretreatment, hydration rate, administration sequence, flushing tube, placement time, drip rate for chemotherapy injection increased from 76%, 50%, 94%, 50%, 54%, 54% before providing full-course pharmaceutical course (May-Jul. 2017) to 100%, 100%, 100%, 100%, 94% and 96% after providing full-course pharmaceutical course (Sept.-Nov. 2017). CONCLUSIONS: The development of full-course pharmaceutical care in day-time chemotherapy center can improve the utilization of medical resources, patient compliance and rational drug use.
期刊: 2019年第30卷第12期
作者: 周琴,刘馨,李然,周黎,薛苏冬
AUTHORS: ZHOU Qin,LIU Xin,LI Ran,ZHOU Li,XUE Sudong
关键字: 全程化药学服务;日间化疗中心;临床路径;静脉用药调配中心
KEYWORDS: Full-course pharmaceutical care; Day-time chemotherapy center; Clinical pathway; Pharmacy intravenous admixture service
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