Excellent model essay for graduation thesis of Pharmaceutical College1; Discussion on the countermeasures of developing clinical pharmacy.
Clinical pharmacy is a subject that studies the effective, rational and safe use of drugs for patients, and it is the product of the combination of modern pharmacy and clinic. This discipline shifts the traditional focus of hospital pharmacy service from drugs to patients, which is the focus and research direction of hospital pharmacy development at present and in the future. At present, clinical pharmacy has entered a substantive development stage, and clinical pharmacy has accumulated some experience from conflict to recognition, from compulsion to consciousness.
First, the specific work practice
1. Combination of rounds and clinical pharmacy work
Pharmacists should combine regular rounds with patrol rounds, make clear the medication plan and solve the medication problem in time. They can arrange designated pharmacists to choose relatively fixed departments, such as general surgery, respiratory medicine, cardiothoracic surgery, etc. , and regularly visit other departments every week. Design a pharmacist's rounds record, including basic information of patients, introduction of course of disease, opinions on rounds, basic medication, etc. After rounds, pharmacists should make suggestions on clinical medication according to patients' conditions, focusing on rational use of antibacterial drugs [1]. The pharmacist's rounds record should be made in duplicate, one in the medical record and the other kept by the pharmacist himself, and the attending physician is required to write the pharmacist's opinions in the course record, and if he agrees, it will be implemented, and if he disagrees, he will explain the reasons. Through ward rounds, clinical pharmacists have increased the chances of contact with clinicians, gradually became familiar with the basic knowledge of relevant departments and mastered the skills of communicating with patients. At the same time, new drug knowledge and compatibility taboos can be transmitted to medical staff in time to give full play to the complementary advantages of drugs. Through the continuous training of pharmacists, drug-induced diseases can be minimized and patients' medication compliance can be improved.
2. Strengthen the supervision of drug use in departments
Clinical pharmacists should strengthen the supervision of clinical medication and promote the rational use of antibiotics. At present, there is abuse of antibiotics in hospitals at all levels in China, and there are many irregularities in the application of antibiotics in our hospital. In this case, clinical pharmacists should randomly check a certain proportion (30%) of discharged medical records every month and register them one by one according to the pre-designed form. Statistics of the utilization rate of antibacterial drugs, inspection rate of therapeutic antibacterial drugs and irrational use of antibacterial drugs in the hospital and departments, written feedback on the use of antibiotics by each doctor, and feedback on the irrational use of antibacterial drugs in each department. You can also conduct spot checks on operating medical records, formulate corresponding reward and punishment systems, and publicize them in writing.
3. Supervision of outpatient medication.
Clinical pharmacists can spot-check outpatient prescriptions regularly, put forward suggestions on rational drug use, spot-check a certain proportion of outpatient prescriptions and anesthesia prescriptions every month, register according to a pre-established form, including the patient's name, gender, diagnosis and drug use, and feed back the prescriptions found to be irregular or irrational in writing to doctors every time, and report the inspection results to the medical department for punishment according to regulations [3], and notify and publicize them through various forms. Irregular writing is mainly manifested in omission, scribbling, no clinical diagnosis or irregularity, no common name, no dosage form or instruction, mixed writing in Chinese and English, etc. The nonstandard use of antibiotics mainly includes inaccurate dosage, inconsistent diagnosis and medication, incompatibility, repeated medication and so on. Through persistent inspection, the quality of outpatient prescriptions in our hospital has been obviously improved.
4. Do a good job in medication consultation.
A medical consultation room is set up in the hospital with obvious signs, and the consultation telephone number is announced to patients and medical staff. Every day, pharmacists with intermediate or above titles are arranged to consult in turn, and professional books are equipped, and consultation records are filled in carefully, including patient's name, age, disease name, contact information, consultation content and answers. Pharmacists have established a good relationship with patients and doctors through medication consultation, improved the compliance of outpatient medication, answered the doubts of patients in the process of medication, corrected some patients' incorrect medication methods in time, and cooperated with clinicians.
5. Try to establish medical records.
The basic idea of establishing medical records for patients taking drugs for a long time is to establish files for the target patients, mainly including the patients' basic drug use, the medical history and drug use of major diseases, and adverse drug reactions. At the same time, the patient's condition changes, related important examinations, proposed medication treatment plan, and medical history summary. Medication records should include the starting time, actual medication situation, withdrawal time, efficacy evaluation, etc. , and timely supplement the patient's new medication information. The medication information of medication records should be timely.
6. Adverse drug reactions
Each clinical department should have a designated adverse drug reaction detector. If any adverse drug reaction is found, it shall be notified to the clinical pharmacy room in time, and registered and reported by the pharmacy personnel. Clinical pharmacists should consult and observe patients' medication carefully and be good at finding adverse drug reactions. Quit Clinical Drug News regularly, which involves problems found in rounds and spot checks, exchange experiences, new drug knowledge and collected pharmaceutical knowledge, and send them to clinical medical departments for reference, and take certain incentive measures to encourage medical staff to actively contribute, and strive to make Clinical Drug News a platform for hospital pharmacists and clinicians to communicate.
Second, summary
Clinical pharmacists should make great efforts in clinical pharmacy, help solve practical medical problems, provide certain pharmaceutical services for patients, and accumulate certain experience, from strangeness, conflict and suspicion between doctors and patients to gradual recognition, trust and acceptance, and achieve initial results. However, due to limited personnel, unsystematic knowledge and insufficient depth and breadth of clinical pharmacy work, some work has not made substantial progress. However, the joint efforts of pharmacists have been recognized by clinicians and patients, and the effect is satisfactory, which is worthy of clinical promotion.
Excellent model essay for graduation thesis of College of Pharmacy II. On the relationship between ecological civilization and traditional Chinese medicine
Ecological civilization refers to the sum of material and spiritual achievements made by human beings following the objective law of harmonious development of man, nature and society; It refers to the cultural and ethical form between man and nature, man and man, and man and society with harmony, virtuous circle, all-round development and sustained prosperity as the basic purpose [1].
Traditional Chinese medicine has been recorded since the appearance of ancient Chinese characters. It is an independent subject. After thousands of years of development, in the process of continuous practice, it has gradually formed a complete medical theory, accumulated rich clinical experience and created magical medical effects. There are many different types of medical systems in the history of human development, but now most of them have disappeared and replaced by modern western medicine. As a rare independent medical system, Chinese medicine can coexist with modern medicine and play an irreplaceable role of western medicine, which is closely related to its foothold in human physiological balance, continuous inheritance of predecessors' achievements, full absorption of advanced science, technology and knowledge of various times, and gradual enrichment and development of its own theory. The development history of traditional Chinese medicine is also an important part of the 5,000-year history of ecological civilization construction of the Chinese nation, which reflects the progress of ecological civilization in China [2].
It is a major feature of traditional Chinese medicine to closely link human health with ecological balance and find the connection in practice, so that human beings can live in harmony with nature. As early as the Spring and Autumn Period, most people in the world blamed ghosts and gods for the occurrence of diseases. Doctors in China have long recognized that patients in the human body are related to diet, daily life, joys and sorrows. Later, some doctors used yin, yang, wind, rain, yin and light in nature. Six qi? Explaining the cause with disharmony was the most advanced concept of cause in the history of world medicine at that time. Under the influence of this concept of etiology, all substances in nature can have an effect on human body, and it became the main work of medical scientists at that time to find a good medicine to eliminate the source of disease.
The system composed of biological community and its surrounding environment is called ecosystem. In a normal ecosystem, all parts of the system maintain a dynamic balance between energy flow and material circulation, which is called ecological balance. As a part of ecosystem, human beings, like other creatures in the food chain, play the role of consumers. Once there are problems in human links, the whole ecosystem will be destroyed, and even human extinction will occur. The practice of Chinese medicine is to regard the human body as an ecosystem. If all kinds of physiological activities in the human body are carried out normally and the health condition is good, it will be in a state of balance. When external and internal factors work together, normal physiological activities will be destroyed, the initial balance will be broken and diseases will follow. Various therapeutic drugs and methods are designed to make up for this balance.
In the long-term medical practice, our ancestors discovered life activities such as Tibetan elephants and meridians, pathogenic factors such as six evils and seven emotions, and competition in the pathological process. Positive? 、? Evil? In the presence of two forces, acupoints are the hinge of regulating functions; Internal seven emotions: happiness, anger, worry, thinking, sadness, fear and shock are the mental factors that cause disease, that is, internal factors; External causes: wind, cold, heat, dampness, dryness and fire, including bacteria and viruses. Qi and blood are the driving force of the whole body, as well as internal and external causes. These are the theoretical basis of traditional Chinese medicine, but also the overall functional factors.
Huangdi Neijing and Treatise on Febrile Diseases, two classic medical works, are the products of the transition from perceptual knowledge to rational knowledge. Under the guidance of TCM ideas and methods, the meaningful information such as symptoms, pulse condition and tongue condition collected by four clinics were determined. Certificate? And pass, right? Certificate? Objective to establish different individualized treatment methods based on syndrome differentiation, which is very consistent with individualized treatment proposed by many western doctors today. Yin and yang as the core content of TCM theory? 、? Five elements? The concepts of zang-fu organs and meridians, etiology and pathogenesis, four diagnosis and eight outlines, syndrome differentiation and treatment, and rule of law all reflect that Chinese medicine pays attention to the harmonious coexistence between human body and nature.
Traditional Chinese medicine prescriptions pay attention to monarch, minister and assistant, and each prescription has different compatibility principles, which also reflects the significance of ecological balance. Every medicine has its curative effect and side effects. The main medicine for treating diseases is monarch medicine, and the medicine that assists monarch medicine to achieve better results is called minister medicine. Drugs that cooperate with monarch drugs to treat two symptoms, or inhibit the toxicity of monarch drugs or adjuvant drugs, are called adjuvant drugs, which means that all drugs are directed to the affected part, or four drugs interact with each other, which can help the human body restore physiological balance as soon as possible and the disease disappears naturally.
Western medicine uses a lot of chemical drugs, and there are many pollution problems in the production process, which has caused great damage to the natural environment. Different from chemical drugs, the raw materials of traditional Chinese medicine are all renewable resources in nature, mainly plants, which conforms to human eating habits and the popular concept of developing low-carbon economy and protecting the environment. Nowadays, many people pay attention to eating medicinal foods suitable for their own health care, such as Houttuynia cordata, purslane, yam, medlar, etc., which often appear on our dining table, which is very conducive to our goal of improving the quality of the whole people and living in harmony with nature. For many emerging diseases, it is difficult for western medicine to find effective treatments in a short time. The application of Chinese medicine in the prevention and treatment of SARS in China and the global epidemic of influenza H 1N 1 has played a great role. For the sudden epidemic, Chinese medicine workers provided corresponding prescriptions in time, which avoided the chances of many susceptible people getting sick and bought time for vaccine research and development institutions.
The main goal of ecological civilization is harmonious and sustainable development, and medicine, as an important part of social economy, has a vital influence. With the development of Chinese medicine today, in order to make people all over the world enjoy the health brought by Chinese medicine culture, we have gradually explored a road of combining Chinese and western medicine. On the one hand, under the guidance of traditional Chinese medicine theory and western medicine theory, we constantly select Chinese medicines with good clinical effects to systematically study their components, find out the truly effective components in plants, monitor and monitor their activity and quality by using advanced monitoring and analysis methods, and develop more new drugs from renewable resources; On the other hand, organically combine the essence of Chinese medicine theory with western medicine theory, and formulate personalized treatment plan according to patients' own characteristics, so as to minimize patients' pain, reduce medical expenses and improve economic benefits accordingly.