A complete organizational structure is the basis to ensure the quality of pharmaceutical services. So, what is the role of hospital pharmacy management in clinical pharmacy service?
With the implementation of medical reform in China, the content of hospital pharmacy management has also changed accordingly, from the traditional drug guarantee supply to providing pharmaceutical technical services for clinic. In order to meet the clinical needs and play its role in pharmaceutical care, the methods and contents of hospital pharmaceutical affairs management must keep pace with the times [1]. In recent years, our hospital has established a modern clinical pharmaceutical service system with rational drug use as the core by summing up many years' experience in pharmaceutical affairs management and combining with foreign modern management science. The system not only provides drug guarantee for clinical treatment, but also significantly improves the quality of pharmaceutical service, further highlighting the role and value of hospital pharmaceutical affairs management in clinical pharmaceutical service. The contents of the pharmaceutical service system in our hospital are briefly described as follows:
1 Improve the organizational structure
A complete organizational structure is the basis to ensure the quality of pharmaceutical service, and it is also an important content of hospital pharmaceutical affairs management. Our hospital has improved the original hospital pharmacy management organization, and set up a clinical pharmacy room and an intravenous drug preparation center, which has provided a guarantee for improving the quality of clinical pharmacy service.
1. 1 Set up the clinical pharmacy room.
Three pharmacists with master's degree in pharmacology and years of clinical experience were selected to set up a clinical pharmacy room. The work of the clinical pharmacy room is as follows: (1) It is necessary to go deep into clinical departments and wards, collect data such as methods, doses and adverse reactions of clinical drugs, analyze and summarize them and feed them back to all departments; (2) Participate in the discussion of clinical medication and guide clinical medication from the perspective of professional pharmacy; (3) Responsible for consultation on adverse drug reactions, solving medication problems for clinicians and answering patients' questions; (4) Provide medical staff with information on new drugs and matters needing attention in drug use in time, and prepare prescription manuals regularly according to the drug use situation, so as to exchange drug use information with clinicians; (5) Training and explaining pharmaceutical knowledge to clinical medical staff through lectures and distributing materials.
1.2 establishment of intravenous drug preparation center.
The intravenous drug preparation center is composed of nurses, professional pharmacists and pharmacists, and its work contents are as follows: (1) It is responsible for the preparation of routine intravenous infusion drugs; (2) Preparation of chemotherapeutic drugs; (3) Preparation of parenteral nutrient solution. Intravenous medication can be uniformly prepared by intravenous medication center, which can greatly reduce the occurrence of adverse reactions caused by intravenous drip and improve the rationality and safety of medication. The main reasons are as follows: (1) Professional pharmacists equipped in the intravenous drug dispensing center are responsible for the inspection of clinical drugs, especially the interaction and incompatibility of combined drugs, so as to reduce medication errors, improve the safety and reliability of clinical drugs and ensure the quality of clinical pharmaceutical services; (2) The preparation center has perfect dispensing and sterilization facilities, and the professional level of the staff is high, which effectively prevents the pollution in the preparation process and improves the work efficiency and the safety of clinical medication; (3) The establishment of the intravenous drug preparation center has improved the protection level of toxic drug exposure collected by the paper consortium. Therefore, the establishment of intravenous drug dispensing center is of great value to improve the quality of clinical pharmaceutical service.
2. Give full play to the role of pharmacists in clinical pharmaceutical service.
Giving full play to the role of clinical pharmacists in clinical pharmaceutical service is a necessary guarantee to improve the quality of pharmaceutical service and clinical efficacy. On the basis of clinical pharmacists' participation in ward rounds and clinical drug preparation, pharmacists should also supervise the rationality of all clinical drugs in the hospital, and focus on checking and monitoring special patients and special drugs. To ensure the rationality and safety of clinical medication.
2. 1 rational drug use
Rational drug use can not only ensure clinical efficacy, reduce adverse reactions and improve the safety of clinical medication, but also affect the prognosis and quality of life of patients, and even have an important impact on the treatment of future diseases. With the improvement of medical technology, more and more clinical research on rational drug use has become an important topic in clinical research. To ensure rational use of drugs in clinic, we should start from the following aspects: (1) Fully understand the clinical value of rational use of drugs: Pharmaceutical administration departments, pharmacists and clinicians should realize that rational use of drugs is an effective way for medical institutions to make use of drug efficacy, reduce drug toxicity, prevent drug-induced diseases, and prevent drug abuse and repeated use. Establish the consciousness of rational drug use fundamentally, and lay a theoretical foundation for the implementation of rational drug use in clinic; (2) Fully understand the contents of rational drug use: ① The premise of ensuring the normal use of rational drugs is to improve the level of rational drug use of clinicians, pharmacists and nurses, and to formulate a sound evaluation system and management system before; ② Give the patient an accurate diagnosis, and give appropriate drugs according to the diagnosis results and the physical characteristics of the patient, so as to achieve the goal of symptomatic treatment; ③ According to the specific conditions of the selected drugs and patients, the corresponding usage, dosage and administration time were adopted [2]. In the process of medication, we should follow the principle of minimizing the types of drugs, and pay strict attention to the compatibility of drugs when combined medication is necessary; ④ Pharmacists should closely observe and count the side effects and adverse reactions of drugs in the process of drug use, so as to ensure the safety of drug use and provide basis for drug screening and elimination.
2.2 Antibiotic medication management
Antibiotics are commonly used drugs in clinic, and they also have high adverse reactions and complications in clinic. Therefore, intravenous antibiotics should be managed and operated in strict accordance with clinical regulations. The clinical regulations for specific operations are as follows: (1) The clinical use of antibiotics should be strictly in accordance with the prescriptions of clinicians? Application form for intravenous medication? And attachment? Application form for antibiotic use? Contents of administration. If there are no vouchers or incomplete vouchers, they should refuse to take drugs and give drugs to patients immediately after communicating with clinicians; (2) Strictly control the clinical dosage. Under normal circumstances, intravenous antibiotics should not exceed three days; (3) For some drugs prone to allergic events, skin tests should be done strictly, and patients should be closely monitored during medication. According to the above regulations, the abuse of intravenous antibiotics can be effectively reduced, and the adverse reactions and side effects of drugs can be reduced, thus ensuring clinical efficacy and improving drug safety.
2.3 intravenous drug management
Intravenous administration has the advantages of quick onset and has become an important way of clinical administration. Intravenous administration has brought a lot of convenience to clinic, but at the same time, the incidence of adverse reactions of intravenous administration has also increased significantly, which has become an important reason affecting clinical efficacy. In 1990s, after studying the intravenous medication and operation, the who Action Safety Committee on Essential Drugs formulated various intervention methods in the process of intravenous infusion, which effectively reduced unnecessary adverse reactions [3]. Research shows that in developed areas and places with high medical level, the utilization rate of intravenous drugs is low and the time of drug abuse is short. Referring to the research results and clinical experience, our hospital has formulated the regulations on intravenous drug use: (1) All clinical intravenous drugs should be prescribed by doctors? Application form for intravenous medication? , by the pharmacist review, approval and signature before medication; (2) Intravenous infusion of antibiotics should be carried out in strict accordance with the mode of administration of antibiotics; (3) Clinical use? Albumin injection? When using an expensive drug, it should be used in the following situations? Application form for intravenous medication? At the same time, attach the clinical test report before clinical medication. The above regulations effectively control intravenous medication, reduce the abuse of clinical medication, reduce the occurrence of adverse reactions, and improve the efficacy and safety of clinical medication [4].
3 Computerization of clinical pharmaceutical services
With the wide application of computer technology, computerization of clinical pharmaceutical services has become the development direction of clinical pharmaceutical services. The application of computer in clinical pharmaceutical service involves inventory control, doctor's advice and prescription, pricing and charging. Computerized clinical pharmaceutical service has the following advantages: (1) electronic prescription: electronic prescription can omit many intermediate links in clinical application and does not need to be priced. Doctors can communicate directly with pharmacies through the hospital network, and directly prescribe drugs and draw prices through computers [5]. Patients can go directly to the pharmacy to get medicine. At the same time, the computer clearly shows the inventory of drugs. If there is a shortage of drugs, doctors can learn directly from the computer and switch to other drugs in time. Provide convenience for doctors and patients; (2) Improve work efficiency: As a complete computer management system is equipped in pharmacies, clinics, wards and other departments, it not only simplifies management procedures, but also improves the speed and quality of service and management, thus effectively reducing the labor intensity of staff; (3) Give full play to the role of pharmacists: The application of electronic pharmaceutical services frees pharmacists from heavy paperwork and enables them to engage in pharmaceutical services better. It not only improves the efficiency and quality of clinical pharmaceutical services, but also effectively improves the safety and effectiveness of clinical medication [6].
Since the implementation of the new hospital pharmacy management in our hospital, the quality of clinical pharmacy service has been significantly improved, the clinical drug efficacy has been significantly improved, and the incidence of drug abuse and adverse reactions has been reduced. Therefore, hospital pharmacy management plays an extremely important role in clinical pharmaceutical service.
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