“新医改”背景下重庆市公立医院药师的工作现状与对策研究
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篇名: “新医改”背景下重庆市公立医院药师的工作现状与对策研究
TITLE:
摘要: 目的:调查公立医院综合改革后重庆市公立医院药师的工作现状,以提出对策及建议。方法:采用问卷调查法,选择重庆市33家二级及以上公立医院的药师为调查对象进行问卷调查,以了解工作现状,调查时间为2018年7-8月,主要从药师基本情况、医改政策的影响、对药师的认可情况及职业成长需求等4个方面进行调查。结果:33家医疗机构包括三级医院13家、二级医院20家;共发放问卷838份,回收有效问卷702份,有效回收率为83.8%。调查结果显示,重庆市公立医院药师以25~35岁居多(50.6%);博士学历的8人(1.1%)、硕士学历的86人(12.3)%、大专和中专学历约占25.9%,三级医院的硕士、博士学历人数高于二级医院,但三级医院仍有专科和中专学历人员;以中、初级职称为主,其中中级职称217人(30.9%)、初级职称434人(61.8%);专业以药学为主(64%),其次为中药学(18.7%);工作年份以10年内居多(54.9%);年收入<5万元的有274人(39.0%),年收入5~10万元的有342人(48.7%),年收入>10万元的仅有86人(12.3%)。医改后,有430人(61.3%)认为工作量明显增加或略有增加,99人(14.1%)认为工作范围明显增加,433人认为年收入略有减少或明显减少(61.7%);有253人(36.0%)认为医院领导不重视或非常不重视药师,有294人(41.9%)认为医护人员比较认可或非常认可药师;药师认为不被重视的原因主要包括患者不理解、临床医务人员不认同、领导不重视、缺乏相应的制度和法规、专业素质不足等5个方面。目前药师主要工作内容以药品调剂为主,而从事临床药学服务、药库管理、药事管理和质量监控、制剂配制、药学研究的较少;希望从事的工作以临床药学服务、药品调剂、药事管理及质量监控为主。除药品调剂及发放外,审核医嘱、用药教育指导、会诊与用药咨询、药品管理等为药师的重要技能,擅长技能则主要为审核医嘱、用药教育指导、药品管理等方面。结论:目前重庆市公立医院药师存在总体学历水平偏低,临床药学专业人员较少,整体收入不高,不被认可等问题。建议从法律政策层面保障药师在医疗过程中的作用和地位,同时引进临床药学专业高学历人员,改善药师队伍专业和学历结构,转变药学服务模式,提升药师能力及提高其待遇。
ABSTRACT: OBJECTIVE: To investigate the current status of pharmacists in public hospitals from Chongqing after the comprehensive reform of public hospitals, to put forward countermeasures and suggestions. METHODS: In questionnaire survey, pharmacists were selected from 33 public hospitals of secondary grade and above in Chongqing as survey objects. The current status of pharmacists in public hospitals of Chongqing from Sept. to Aug. 2018 was collected and surveyed in respects of the basic situation of pharmacists, the impact of medical reform policies, acceptance and professional development requirements of pharmacists. RESULTS: Totally 33 medical institutions included 13 third-grade hospitals and 20 secondary hospitals. A total of 838 questionnaires were distributed and 702 questionnaires were effectively recovered with effective recovery rate of 83.8%. According to the survey results, the majority of pharmacists in public hospitals of Chongqing were 25-35 years old (50.6%); 8 (1.1%) had doctor’s degree, 86 (12.3%) had master’s degree, and 25.9% had junior college and technical secondary schools. The number of master’s and doctor’s degrees in third-grade hospitals was higher than that of secondary hospitals, but there were still junior college and technical secondary school degrees in third-grade hospitals. Pharmacists were mainly referred to as middle and junior titles, 217 of which were middle-level titles (30.9%), and 434 were primary titles(61.8%); the majors were mainly pharmacy (64%), followed by traditional Chinese pharmacology (18.7%). Most of the working years were within 10 years (54.9%). There were 274 people (39.0%) with an annual income of less than 50 000 yuan, 342 people (48.7%) with an annual income of 50 000- 100 000 yuan and only 86 people (12.3%) with an annual income of more than 100 000 yuan. After the implementation of new medical reform, 430 people (61.3%) thought that the workload had increased significantly or slightly, 99 people (14.1%) thought that the scope of work was significantly expanded, and 433 people thought that the annual income after medical reform was slightly reduced or significantly reduced (61.7%); 253 people (36.0%) believed that hospital leaders did not pay attention to and did not pay much attention to pharmacists; 294 (41.9%) believed that medical staffs relatively accepted or highly accepted pharmacists. The reasons why pharmaceutical staffs thought that they were not valued mainly included five aspects, including that patients did not understand them; clinical medical staff did not agree with them; leaders did not pay attention to them; corresponding systems and regulations lacked; professional quality lacked. The main work content of pharmacists was mainly based on drug dispensing, and there were fewer people carrying out clinical pharmaceutical care, pharmacy management, pharmaceutical administration and quality control, preparation, pharmaceutical research. The jobs that they hoped to engage in were clinical pharmaceutical care, drug dispensing, pharmaceutical administration and quality monitoring, etc. Pharmacists believed that drug dispensing and delivery, reviewing medical orders, medication education guidance, consultation and medication counseling, drug management were important skills. The pharmaceutical staffs were good at skills, such as medical order review, medication education guidance, drug management. CONCLUSIONS: At present, the pharmacists in public hospitals of Chongqing have some problems, such as low education level, few clinical pharmaceutical professionals, low overall income and not recognized. It is suggested to protect the role and position of pharmacists in the medical treatment process from the perspective of introducing highly educated personnel of clinical pharmacy, improving the professional and educational structure of pharmacists, changing the pharmaceutical care mode, and improving their own ability and treatment.
期刊: 2019年第30卷第24期
作者: 李方方,邓莉,沈鹏,王皓,严波
AUTHORS: LI Fangfang,DENG Li,SHEN Peng,WANG Hao,YAN Bo
关键字: 新医改;重庆;公立医院;药师;工作现状;对策
KEYWORDS: New Medical Reform; Chongqing; Public hospital; Pharmacist; Work status; Countermeasure
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