1. Try to participate in rounds in clinical departments every day, provide rational drug use consultation for clinicians and patients, establish drug calendars for key patients, and write three drug calendars every month.
2. Cooperate closely with the clinic and participate in clinical consultation and discussion of death medical records in time when necessary.
2. Prescription random inspection
1. Prescriptions of narcotic drugs and psychotropic drugs of category I: write prescriptions and check the rational use of drugs for all such drugs, and feed back the problems found to the dispensing department in time.
2. Prescriptions of psychotropic drugs of category II: 1 prescriptions of this category are randomly selected every month for prescription writing and rational drug use inspection.
3. Common prescriptions (including emergency prescriptions and pediatric prescriptions): assist the dispensing department and the department director to complete the summary of this kind of outpatient prescriptions every month.
4. Fill in the prescription evaluation form every month according to the requirements of Prescription Management Measures.
The problems in prescriptions should be published in each issue of Clinical Drug News to remind clinicians to pay attention to prescription writing and rational drug use.
3. Spot-check of medical records
1. Spot-check 2 inpatient medical records of each department every month to check the rationality of drug use (especially the rationality of antibacterial drug use), feed back the inspection results to the clinic and submit them to the quality control department for inclusion in the medical record quality assessment.
2. Every quarter, 1 inpatient medical records of three clinical departments were randomly selected as planned, and the usage of the top 1 antibacterials was checked, and the inspection results were analyzed and fed back to the clinical departments.
3. Check 3 surgical medical records every month to check the use of antibiotics during perioperative period, and analyze the inspection results.
4. Investigate the use of antibacterial drugs in 1 inpatient medical records every month, and make a summary analysis every quarter.
iv. analysis of drug use
make statistics on the consumption sum and quantity of outpatient drugs and inpatient drugs respectively every quarter, and analyze the rationality of drug use.
V. Adverse Drug Reactions
Supervise and collect adverse drug reactions in clinical departments, instruct relevant personnel to fill in the adverse drug reaction report form, and report it to Sichuan Adverse Drug Reaction Monitoring Network before 25th of each month.
VI. Clinical Drug News
Clinical Drug News is published once every quarter, including prescription analysis, drug use analysis, adverse drug reactions, information corner and other columns, with four issues throughout the year.
VII. Spot check of drug quality
Spot check the appearance quality of three drugs (one for oral administration, one for injection and one for external use) in the drug storehouse every month.
Work Plan II for Clinical Pharmacists: Development and Plan of Clinical Pharmacist Work (3,5 words)
I completed clinical pharmacist training in the First Affiliated Hospital of Jilin University at the end of 211 and returned to work. Our hospital began to establish a clinical pharmacist system. After a period of preparatory work, the clinical pharmacy room was formally established in January 212 with the great attention and strong support of President Wang Qi and Vice President Xuan Jihao. Although the related work has been carried out by one person due to the shortage of human resources since its establishment, I have accumulated rich experience in clinical pharmacy work through my unremitting efforts and study in the past six months, successfully completed the scheduled work objectives and tasks, and made a detailed work plan for the smooth development of clinical pharmacy work in the future.
at present, I have developed and will develop the clinical pharmacy work plan as follows:
1. I have formulated the clinical pharmacy work system and annual work target
First, I have formulated the Responsibilities and System of Clinical Pharmacy Room, and at the same time, I have formulated the annual work plan and work target for 212, and made a monthly work summary in time. Make it work institutionalized, operational procedures, and clear responsibilities.
Second, strengthen prescription review and punishment for irrational drug use
Clinical pharmacists randomly check 3 inpatient medical records and more than 5 inpatient electronic medical records every month, and make prescription review and irrational drug use analysis on our hospital's doctor's orders and prescriptions once a month, and feedback the review results and suggestions to the medical and political department. At the same time, relevant systems and regulations have been formulated, such as Prescription Comment System and Regulations on the Management of Clinical Rational Drug Use.
III. Special rectification of antibacterial drugs
Actively participated in the special rectification of clinical application of antibacterial drugs in hospitals, and played a substantial and important role in implementing the three-level management of antibacterial drugs. At present, the utilization rate of prophylactic use of antibacterial drugs for class I incisions in our hospital is generally very high, which can't meet the requirements of superiors at all. The utilization rate of antibiotics prescribed by inpatient and outpatient departments is counted and evaluated by departments or doctors on time every month. In addition, in accordance with the regulations, the rationality of the use of antibiotics in the medical records and outpatient prescriptions of discharged patients is regularly evaluated.
When commenting on the inpatient medical records, we found that there are several problems in the rational use of antibacterial drugs in our hospital:
1) The utilization rate of antibacterial drugs is too high;
2) Antibacterials are used for too long;
3) The selection of antimicrobial agents is unreasonable;
4) the single dose is unreasonable;
5) The timing of preventive drug administration is unreasonable;
6) The frequency of antimicrobial drug administration is unreasonable;
7) It is unreasonable to replace antibiotics;
8) unreasonable combination of drugs;
9) There is no evidence of the use of antibacterial drugs and so on.
In April and June, the electronic prescriptions of outpatient and emergency departments were reviewed with all samples, and the following problems were found:
1) No diagnosis;
2) The diagnosis is inconsistent with the medication;
3) the frequency of administration is unreasonable;
4) the single dose is unreasonable;
5) repeated medication;
6) unreasonable combination of drugs.
V. Strive to create and create an academic atmosphere
Always pay attention to and strengthen the training and improvement of their own professional quality and professional skills, learn from old clinical experts and professors with an open mind, study hard, strive to create and create an academic atmosphere, and create a learning department.
VI. The projects that have been carried out at present are as follows:
1) Writing on time every month:
1. Three copies of the medicine calendar;
2. A case analysis;
3. Two case discussions.
2) Work in progress:
1. It has been carried out in some treatment areas:
(1) Drug intervention and filling in the record sheet;
(2) drug information consultation and filling in the record form;
(3) The hospitalized patients were evaluated in pharmacy and a record form was filled in;
(4) clinical practice record sheet;
(5) Attend the consultation and fill in the consultation record sheet;
(6) Investigate the drug use of inpatients and fill in the forms.
2. Work planned for the next step:
(1) Pharmaceutical education for inpatients and filling in records
(2) Drug guidance for discharged patients and filling in records, etc.
3) Statistical indicators or information reported to the hospital and medical department on time every month:
Statistics on antibacterial drug expense ratio, total antibacterial drug expense, DDDS, utilization rate, the ranking of the top ten drugs and the ranking of the top ten doctors in the hospital were made according to the hospital, inpatient, outpatient, emergency and doctor categories.
VII. Problems and deficiencies at present
Although the clinical pharmacy work has made small achievements and progress in the past six months, due to the lack of personnel, imperfect computer software and other factors, many work projects have not been put into operation, and there is still a big gap between them and the advanced level in the whole province and the whole country.
The specific manifestations are as follows:
1. The working mode of clinical pharmacy is still in the process of exploration and exploration, and all the work needs to be further standardized and concrete, and the implementation and execution of the clinical pharmacist system needs to be improved and improved;
2. Clinical pharmacists lack deeper experience and ability in clinical practice, and their participation in clinical rational drug use needs to be further strengthened and improved;
3. There is a shortage of clinical pharmacy talents, so hospitals should strengthen the introduction of talents in this field and vigorously support the training and continuing education of on-the-job clinical pharmacy personnel;
4. The basic hardware facilities necessary for the work of clinical pharmacy room, such as reference room and instrument room, need to be reasonably solved and improved by the hospital.
VII. Future (long-term) work plan
1. Accelerate the construction of clinical pharmacy team
According to the requirements of clinical pharmacy post allocation of the Ministry of Health, tertiary hospitals should be equipped with at least 5 full-time clinical pharmacists. However, in the first half of the year, only one person in our hospital officially participated in the work of clinical pharmacists, which is extremely incompatible with the hospital's grade and scale and business development. This requires the hospital to strengthen the introduction of clinical pharmacy talents. Recently, two people have been selected for training, and it is necessary to continue to introduce two people with bachelor's degree or above in clinical pharmacy to further enrich and strengthen the construction of clinical pharmacy teams.
2. In the second half of the year, it is planned to feed back the review results and suggestions to the medical administration department, and then the expert group will review them. The final results will be publicized and financially punished through the hospital OA network. The phenomena of incorrect writing of prescriptions, incompatibility of drugs, overdose of drugs, drugs without indications and unreasonable use of antibacterial drugs that are not strictly implemented according to the specifications will be notified on the OA network, and certain economic penalties will be imposed, directly to individuals. It aims to ensure medical quality and safety, improve clinical efficacy, promote the rational and standardized use of drugs, and avoid the recurrence of similar problems.
3. Further improve the monitoring of adverse drug reactions
According to the objectives and management rules of adverse drug reaction monitoring, the adverse drug reaction information of the National Adverse Drug Reaction Center will be timely edited, sorted and notified on the OA website every quarter. At the same time, the hospital's serious adverse drug reactions treatment plan was formulated, and the serious adverse drug reactions that occurred in our hospital were promptly warned and analyzed, reminding the medical staff to strictly grasp the indications, usage and dosage, and strengthen monitoring to prevent the recurrence of serious adverse reactions.
4. Make a good record of ward rounds in the hospital
It is necessary to pass through the clinical departments, make comments on the irrational drug use of key, critical and difficult patients in the departments, analyze and point out the existing problems in drug use and improvement measures. Communicate with department directors and clinicians on individual controversial issues, so as to achieve consensus, mutual understanding, mutual promotion and common development.
5. Instruct the nursing staff to do a good job in obtaining, keeping and using drugs correctly.
Regularly check the expiration date and types of first-aid drugs in the emergency medicine cabinet of clinical departments, guide and train nursing staff in charge of emergency medicine management, and organize relevant personnel in departments equipped with anesthesia, psychiatry and hormone drugs to learn relevant laws, regulations and management systems, so as to ensure the correct application, storage and use of the above drugs.
6. Strengthening the quality education of clinical pharmacy
Clinical pharmacy is a highly professional pharmaceutical practice that is closely combined with clinical practice. It is required that every clinical pharmacist must have solid pharmaceutical knowledge and ideas, 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 pay attention to on-the-job training and continuing education for clinical pharmacy personnel, strengthen the cultivation of clinical practice skills, establish clinical thinking and clinical paths, and strive to create learning departments.
7. Improve the basic construction of clinical pharmacy
Clinical pharmacy reference room and instrument room are the most basic infrastructure of clinical pharmacy. Next year, we will strive for the support and investment of the hospital, and improve the basic facilities such as reference books, periodicals, instruments and equipment necessary for the clinical pharmacy room as soon as possible.
8. Participate in the monitoring of rational drug use
In p>21, the Ministry of Health required tertiary hospitals to participate in the national monitoring of rational drug use. The hospital information center should actively cooperate with the clinical pharmacy room, do the preparatory work as soon as possible, and stress efficiency, so that the network reporting work in our hospital can be realized smoothly as soon as possible.
9. Carrying out monitoring of therapeutic drugs
The design, implementation and monitoring of individualized drug treatment plan require hospitals to carry out monitoring of blood drug concentrations of digoxin and other drugs, so as to provide accurate clinical data for clinicians and objective basis for clinical individualized drug administration.
1. discover, solve and prevent potential or actual medication problems, monitor drug safety and feed back drug safety information in time.
actively strengthen communication and cooperation with the medical staff in the hospital. The medical, pharmaceutical and nursing staff actively discuss the medication problems that appear or may appear in the process of drug use, and announce them in the hospital in time after reaching a conclusion. Establish a perfect monitoring network for adverse drug reactions, collect, analyze and report adverse drug reactions in time. Through prescription evaluation, case analysis, clinical application monitoring of antibacterial drugs and dynamic monitoring of drug dosage, drug safety was monitored and drug safety information was fed back to the whole hospital in time.
11. master the drug information related to clinical medication. To provide medical staff and patients with drug information consulting services, carry out rational drug use education, and guide patients to use drugs safely.
12, combined with the clinical drug treatment practice, the clinical application of drugs and drug risk prevention research; Carry out research on intervention measures and drug utilization evaluation of irrational drug use; To study and evaluate the clinical safety and effectiveness of new drugs after listing.
13. strive for the informatization construction of clinical pharmacy
the informatization construction of clinical pharmacy is an important part of the informatization construction of hospitals. At present, the software of rational drug use has been installed and the clinical pharmacy room has been established. In order to better serve the hospital in clinical pharmacy and improve the software and hardware requirements necessary for the development of modern hospitals, the hospital needs more support and investment, and strive to complete the information construction of clinical pharmacy as soon as possible, so that the clinical pharmacy work can continue to grow and develop, better serve the clinic and serve the patients.
clinical pharmacists, like clinicians, should insist on giving full play to the role of pharmaceutical professionals in the process of drug treatment through clinical practice, and cooperate with doctors and nurses to find, solve and prevent potential or actual drug use problems in clinical drug use practice, so as to promote rational drug use, protect patients' drug use safety, indirectly reduce the occurrence of medical disputes and achieve invisible income for hospitals. Clinical pharmacists need the active cooperation and support of hospital leaders and leaders of clinical departments to do these jobs well.
Our clinical pharmacists will not live up to the expectations of hospital leaders, and will do their best to do a good job in clinical pharmacy, making a contribution to the continuous development and growth of Dunhua Hospital.
The above is my work report for the first half of the year and my next work plan. Please give me criticism and correction.
July 23, 212
Clinical Pharmacist Work Plan III: Summary of Clinical Pharmacist Work in XX Hospital in 214 and Clinical Pharmacy Work Plan in 215 (2,199 words)
With the support of hospital leaders and department directors, I conducted a one-year further study in the clinical pharmacist training base of XX Hospital. After returning this year, I officially became a clinical pharmacist in the Department of Cardiovascular Medicine of our hospital, and successfully completed my work. At the same time, constantly sum up experience in the work and improve their professional level. The work is summarized as follows:
1. Clinical work:
First of all, I am familiar with the clinical work methods and workflow in the cardiology department of our hospital. Because there are two circulation departments in our hospital, under the arrangement of the department director, the two departments rotate alternately every month, and gradually introduce the duties of clinical pharmacists to doctors and patients. While performing the duties of clinical pharmacists' rounds, they answer difficult questions for doctors when using drugs, do a good job in drug education for patients, and provide pharmaceutical services for clinic.
1. Participate in clinical rounds every day, and write records of rounds and medicine calendars in time; Pay attention to the drug use characteristics of the elderly and special people with multiple coexisting diseases, and carry out the whole process of pharmaceutical care for critically ill patients, participate in the whole process of clinical treatment, and assist doctors to adjust the drug treatment plan.
patients in circulatory medicine often exist.