硕士论文-我国推行临床药剂师制度动力阻力分析

华中科技大学硕士学位论文我国推行临床药剂师制度动力阻力分析姓名：王丽颖申请学位级别：硕士专业：社会医学与卫生事业管理指导教师：张新平200805231102020305101015124219622000423245AbstractObjectInordertoadaptthedevelopingoftheworldpharmacycaretopromotesafeeconomicrationalclinicaluseofdrugsperfectmedicinecarechangetheusedofthenegativefunctionofthepharmacyThestudyofthedynamicsandresistanceintheimplementationofclinicalpharmaceuticalinchinainthispaperwillbegoodtothepolicyimprovementandextensioninthefutureDataandMethodsTheoreticalresearchisthemainlymethodinthedatacollectiondatareductionanddataanalysisandtheinvestigationplayanassistedfunctioninthestudyDatacollectionmethodliteraturemethodthroughlibraryinternettosearchbooksjournalselectronicresourcelearnmoreaboutclinicalpharmaceuticalcareclinicalpharmaceuticalpolicyinoroutofchinaandthedataofthesituationofthepolicyimplementationMainlycollectthecasesandtheexperiencedataFieldsurveythisstudyinvestigate10hospitals20doctors20nursesand30pharmacistsintotalhalfofthehospitalsdoctorsnursespharmacistsareinWuhanandtheotherhalfareinShenzhenTheinterviewe-mailandtelephoneareusedinthisinvestigationtogetsomedataaboutwhethertheclinicpharmacistpolicywereimplementedtheresponsibilityofthepharmaciststhesituationofthepolicyimplementationtheconditionofthepolicyimplementationandthesuggestionstheresistancemaybecomeacrossduringthepolicyimplementationandtheanalysisofthesourceDataanalysismethodmainlyusedliteraturemethodincludecaseanalysisinterestgroupanalysisSWOTanalysisandsoonResultsandConclusionsThestudywasbaseonthetheorypracticeandthedistanceoftheimplementationoftheclinicalpharmacistpolicydomesticandoverseasandthesignificantcasesAnditconclude6themaindynamicandresistantfactorsintheimplementationoftheclinicalpharmacistspolicyespeciallyin1DynamicanalysisChinahasaverystrongtheorybasisintheimplementationoftheclinicalpharmacistspolicyTheconceptsuchasthesevenstarpharmacistspharmaceuticalcareevidence-basedpharmacyself-medicationwereproposedthecoreideaistakethepatientsasthecentreofthemedicinethepharmacistsprovidethepharmaceuticalcaretothemedicalstaffpatientsandtheirfamiliesensurethesafetyeffectivenessandeconomicuseofdrugsThereisabundantofdataintheclinicalpharmacistspolicypracticeTheunitedmedicineresearchdevelopingcentreproposedandpassed“theregulationofthetrainingofthecomprehensivemedicinestaff”ofAmericain1970EnsuretheclinicalpracticeofthepharmacystudentsThenewstandardwaspromulgatedbythecommitteein1974”clinicalpharmacyinternstudents”ThestandardofclinicalpharmacyspecificwaswidelyimplementedsuchashowmanytimestheydoclinicalworkeveryweekwhichdepartmentstheymainlyworkinwhattheyalwaysdospecificallyandsoonSomehospitalsinchinahavegetmuchmorefromthetrainingoftheclinicalpharmacyandtheirworkdevelopmentwhichbasedonthelearningofthedevelopedpracticeabroadandthentaketheminsotobeagoodexampletothenextworkofchinaIntheinvestigationtherehavebeen42clinicalpharmaciststrainingpilotsinthepresentinchinaeachpilotdeveloptheworkcombinestoselfcharacteristicssuchasadversereactionmonitoringtherapeuticdrugmonitoringroundsbyclinicalpharmacistsdirectionofmedicationusagethoughithasnotbeenstandardspreadevenroadfortheimplementationoftheclinicalpharmacistpolicyWestillhavealongdistanceonthetheoryandpracticeofclinicalpharmacypolicywithmanydevelopedcountryThepolicydevelopedveryslowinchinaeventhoughitstartedquiteearlytheconceptsuchassevenstarpharmacistpharmaceuticalcareself-medicine7wereprovidedoverseasbuttherearefewwereproposedinchinaClinicalpharmacycareeducationwasstandardizedbythewayoflawinAmericaasearlyas1963butitwasonlymentionedinthedepartmentruletillnowinchinaThePharmDdegreewerewidelyimplementedinAmericafrom2000butthereareonly42trainingpilotshereinchinatodayandsoonWestillhavealongwaytogowehavetoworkhardsoastocatchthehighleveloftheworldTheclinicalpharmacycareimplementationcanimprovethequalificationofthemedicalcareeffectivelyTheimportantworkoftheclinicalpharmacistsincludeclinicalworktherapeuticdrugmonitoringadversedrugreactionmonitoringandsoonthepharmacymustbeasupplementandmonitoringtotheprescriptionbehaviorperfectthispolicynotonlycandecreasethemedicalcostbutalsocanregulatethemedicalcareandpromoterationaldrugusedmakethemedicalcarequalityimprovedmorerationalIntheinvestigationthemedicinestaffofthepilotshaveagoodevaluationtotheclinicalpharmacistspolicythenurseespeciallybelievethatthepharmacistsgivethenmuchhelpindrugusageandtheyhavemanycasesotherobjectsoftheinvestigationholdsthattheimplementationofthepolicywillimprovethequalityofthemedicinecaregreatlyThesignificantcasesinchinathatimplementedtheclinicalpharmacistpolicywillbetheguideoftheworkEventhoughtherearefewhospitalspushedthepolicyashardasChanghaihospitalinchinatheymustbeagoodguidancetothefutureworkTheyaccumulatesomuchexperienceintheclinicalpharmacisttrainingandtheclinicalworkandsoontheymadethepolicywellimplementedinchinaquitepossible2ResistantanalysisTheextentoftheclinicalpharmacistpolicyrelatedlawguaranteeisnotenoughTemporaryRegulationsofPharmacyAffairsforMedicalInstitutionsjustadepartmentrulethefunctionisquitelimitedandthecontentissimpleithinderedthepolicyd