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| 儿科门急诊药房用药指导现状与患者需求调研 |
| 牛振喜
1,贾运涛
2,王晓玲
3,马姝丽
1,李超
3,孙燕燕
4 |
|
|
| (1.
郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,郑州
450018;2.
重庆医科大学附属儿童医院,重庆 400014;3.
国家儿童医学中心/ 首都医科大学附属北京儿童医院临床研究中
心,北京 100045;4.
天津市儿童医院,天津 300074) |
|
| 摘要: |
| 目的:对儿科门急诊药房的用药指导需求和现状进行深入调研与分析,并提出相应的规范化管理策略。 方法:通过问卷
对全国 12 家省市儿童医院进行调研,应用 SPSS
25. 0 和 R4. 0. 3 软件进行统计。 结果:18 项用药指导的咨询条目中“经常咨询+
偶尔咨询”的占比均超过了 50%,显示出高度的需求。 经常咨询占比排名前五的条目:用药时间注意事项(68. 65%)、药品分剂
量注意事项(57. 24%)、药品贮藏注意事项(47. 36%)、用药疗程(46. 68%)、特殊剂型用法及注意事项(40. 37%)。 然而,儿科门
急诊药师在实际工作中能够主动提供完全指导的比例相对较低,20 项用药指导的各条目做到总能告知的平均占比只有
42. 19%。 执行程度得分前 5 位的是药品贮藏注意事项(4. 63 分)、药品特殊使用条件(4. 62 分)、特殊剂型用法及注意事项
(4. 38 分)、药品分剂量注意事项(4. 36 分)、用药时间注意事项(4. 36 分)。 得分后五位的是药品的适应证(3. 72 分)、用药后的
不良反应及处理措施(3. 69 分)、喂药技巧与对策(3. 65 分)、漏服或吐药后的处理措施(3. 50 分)、药品口味(3. 49 分)。 初级职
称比中级及以上职称做到总能执行的程度更高(OR= 0. 331 ~ 0. 635,P<0. 05),工作年限越长的药师做到总能执行的程度更高
(OR= 1. 019~1. 035,P<0. 05)。 职称是整体执行程度评分的影响因素(P<0. 05),初级职称比中级及以上职称总体执行程度更
高。 门急诊工作中,在窗口配发药品时进行用药交代是最主要的用药指导形式,占比 87. 22%。 药师未能做到全面指导的原因
调查显示,高峰期患者量大,时间有限来不及做到全面指导(86. 91%)占比最高。 结论:当前儿科门急诊药房的用药指导状况并
未满足患者的需求,需要在内容、形式及培训等方面实施规范化管理,以提高服务质量。 |
| 关键词: 儿科 门急诊药房 用药指导 需求与现状 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.09.005 |
|
| 基金项目:河南省医学科技攻关联合共建项目,编号 LHGJ20220768。 |
|
| InvestigationonCurrentSituationofMedicationGuidanceandPatients’NeedsinPediatricOutpatientandEmergencyPharmacy |
| Niu
Zhenxi
1,
Jia
Yuntao
2,
Wang
Xiaoling
3,
Ma
Shuli
1,
Li
Chao
3,
Sun
Yanyan
4 |
| (1.
Children’ s
Hospital
Affiliated
to
Zhengzhou
University,
Henan
Children’s
Hospital,
Zhengzhou
Children’s
Hospital,
Zhengzhou 450018,
China;
2.
Children’s
Hospital
of
Chongqing
Medical
University,
Chongqing 400014,
China;
3.
Clinical
Research
Center,
National
Children’s
Medical
Center/ Beijing
Children’s
Hospital,
Capital
Medical
University,
Beijing 100045,
China;
4.
Tianjin
Children’s
Hospital,
Tianjin 300074,
China) |
| Abstract: |
| Objective:
To
investigate
and
analyze
the
needs
and
current
situation
of
medication
guidance
in
Pediatric
Outpatient
and
Emergency
Pharmacy,
so
as
to
put
forward
corresponding
standardized
management
strategies.
Methods:
A
questionnaire
survey
was
performed
on
12
provincial
and
municipal
children’ s
hospitals
in
China,
SPSS
25. 0
and
R4. 0. 3
software
were
used
for
statistical
analysis.
Results:
Among
the
18
medication
guidance
consultation
items,
the
combined
proportion
of
“frequent
consultation
+
occasional
consultation”
exceeded
50%,
indicating
a
high
level
of
needs.
The
top
5
items
with
frequent
consultation
were
respectively
precautions
for
medication
timing
(68. 65%),
precautions
for
drug
dosage
(57. 24%),
precautions
for
drug
storage
(47. 36%),
medication
course
(46. 68%),
and
usage
and
precautions
for
special
dosage
forms
( 40. 37%).
However,
the
proportion
of
pediatric
emergency
pharmacists
who
could
actively
provide
complete
guidance
in
the
actual
work
was
relatively
low,
with
an
average
proportion
of
each
item
of
medication
guidance
being
only
42. 19%
in
20
items.
The
top
5
items
with
the
highest
degree
of
implementation
were
precautions
for
drug
storage
(4. 63
points),
special
conditions
for
drug
use
(4. 62
points),
usage
and
precautions
for
special
dosage
forms
(4. 38
points),
precautions
for
drug
dosage
(4. 36
points),
and
precautions
for
medication
timing
(4. 36
points).
The
5
items
with
the
lowest
degree
of
implementation
were
indications
of
drugs
(3. 72
points),
adverse
drug
reactions
and
treatment
measures
after
medication
(3. 69
points),
feeding
skills
and
countermeasures
(3. 65
points),
treatment
measures
after
missing
or
vomiting
drugs
(3. 50
points),
and
drug
taste
(3. 49
points).
Pharmacists
with
a
junior
title
showed
a
higher
overall
implementation
degree
compared
with
those
with
an
intermediate
title
and
above
(OR= 0. 331
to
0. 635,
P<0. 05),
and
pharmacists
with
longer
working
years
were
more
likely
to
consistently
provide
complete
guidance
(OR= 1. 019
to
1. 035,
P<0. 05).
Professional
titles
were
influencing
factors
on
the
overall
implementation
degree
score
(P<0. 05),
with
junior
titles
showing
better
implementation
than
intermediate
titles
and
above.
In
the
Outpatient
Emergency
Department,
medication
explanation
was
the
most
important
form
of
medication
guidance
during
drug
dispensing
at
the
window,
accounting
for
87. 22%.
The
investigation
of
reasons
why
pharmacists
failed
to
provide
comprehensive
guidance
revealed
that
a
larger
number
of
patients
during
peak
periods
led
to
limited
time
and
inability
to
offer
comprehensive
guidance
(86. 91%).
Conclusion:
The
current
medication
guidance
in
Pediatric
Outpatient
and
Emergency
Pharmacy
fails
to
meet
patients’
needs.
It
is
necessary
to
implement
standardized
management
in
terms
of
content,
form
and
training
to
improve
the
quality
of
service. |
| Key words: Pediatrics Outpatient
and
Emergency
Pharmacy medication
guidance needs
and
current
situation |
