本文選題：藥品不良反應(yīng)　切入點(diǎn)：醫(yī)療機(jī)構(gòu)　出處：《成都中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：隨著醫(yī)藥工業(yè)的發(fā)展,藥品的安全性日益受到廣泛關(guān)注。藥品不良反應(yīng)(Adverse drug reactions, ADR)監(jiān)測(cè)工作也逐步向規(guī)范化、科學(xué)化方向發(fā)展。藥藥品不良反應(yīng)監(jiān)測(cè)是保證患者安全用藥的基礎(chǔ)。藥品不良反應(yīng)監(jiān)測(cè)體系完善程度及監(jiān)測(cè)工作實(shí)施力度直接影響藥品安全性監(jiān)測(cè)的質(zhì)量。醫(yī)療機(jī)構(gòu)是直接面對(duì)患者使用藥品的主要場(chǎng)所,醫(yī)療機(jī)構(gòu)對(duì)藥品不良反應(yīng)監(jiān)測(cè)的重視程度是影響藥品安全性監(jiān)測(cè)的主要因素,從而影響到人體的安全用藥。 本文選取四川地區(qū)20家醫(yī)療機(jī)構(gòu),對(duì)該20家醫(yī)療機(jī)構(gòu)藥品不良反應(yīng)監(jiān)測(cè)機(jī)構(gòu)的設(shè)立、人員配備、辦公場(chǎng)所、辦公設(shè)備、監(jiān)測(cè)網(wǎng)絡(luò)系統(tǒng)、監(jiān)測(cè)人員培訓(xùn)、監(jiān)測(cè)工作開(kāi)展過(guò)程中相應(yīng)制度的建立情況等進(jìn)行問(wèn)卷調(diào)查分析,收集我國(guó)四川地區(qū)醫(yī)療機(jī)構(gòu)藥品不良反應(yīng)監(jiān)測(cè)工作中關(guān)于人員素質(zhì)、設(shè)施配備等軟、硬件等方面的數(shù)據(jù)。 調(diào)查分析顯示20家醫(yī)療機(jī)構(gòu)對(duì)ADR的監(jiān)測(cè)及相應(yīng)的軟件及硬件配備率都在35%-50%之間,未占半數(shù)。專(zhuān)職人員配備率為35%,人員培訓(xùn)制度建立率為30%、藥品不良反應(yīng)監(jiān)測(cè)工作考核制度的建立率為20%。在國(guó)家藥品不良反應(yīng)監(jiān)測(cè)系統(tǒng)中注冊(cè)率占70%,填報(bào)《藥品不良反應(yīng)／事件病例報(bào)告表》率占70%。三甲醫(yī)院在監(jiān)測(cè)人員、設(shè)備配備、制度建立等方面較好于二甲醫(yī)院,但大多數(shù)醫(yī)院都對(duì)死亡、嚴(yán)重、群發(fā)、突發(fā)不良事件的應(yīng)對(duì)制度未建立,一但發(fā)生重大ADR將可能產(chǎn)生嚴(yán)重藥品安全隱患。 本文針對(duì)醫(yī)療機(jī)構(gòu)的實(shí)際情況,結(jié)合文獻(xiàn),認(rèn)為醫(yī)療機(jī)構(gòu)應(yīng)建立全面的ADR監(jiān)測(cè)系統(tǒng),特別是基礎(chǔ)醫(yī)療機(jī)構(gòu)的ADR監(jiān)測(cè)系統(tǒng)的建立(建立藥品良反應(yīng)監(jiān)測(cè)體系、配套的藥品不良反應(yīng)監(jiān)機(jī)構(gòu)、保證ADR監(jiān)測(cè)工作正常開(kāi)展的制度、ADR監(jiān)測(cè)數(shù)據(jù)庫(kù)) 在具體的ADR監(jiān)測(cè)工作中應(yīng)對(duì)醫(yī)務(wù)人員進(jìn)行系統(tǒng)的ADR的上報(bào)流程和上報(bào)方法的培訓(xùn)、樹(shù)立醫(yī)務(wù)人員不良反應(yīng)監(jiān)測(cè)報(bào)與促進(jìn)合理用藥及臨床醫(yī)療安全緊密聯(lián)系的意識(shí)、培養(yǎng)負(fù)責(zé)專(zhuān)門(mén)將藥物信息與臨床科室相互溝通的專(zhuān)業(yè)人員、臨床藥師、減輕醫(yī)療機(jī)構(gòu)上報(bào)ADR的顧慮、增加ADR監(jiān)測(cè)的經(jīng)費(fèi)投入、加強(qiáng)醫(yī)務(wù)人員的用藥知識(shí)、集中重點(diǎn)科室、關(guān)注重點(diǎn)人群進(jìn)行ADR監(jiān)測(cè)、參加疑難或死亡病例討論、重點(diǎn)監(jiān)測(cè)某些易發(fā)ADR的藥品品種、細(xì)心指導(dǎo)患者用藥、充分發(fā)揮護(hù)理人員在ADR監(jiān)測(cè)中的作用,以提高ADR監(jiān)測(cè)工作的質(zhì)量。
[Abstract]:With the development of pharmaceutical industry, more and more attention has been paid to the safety of drugs. The monitoring of adverse drug reactions (ADR) is the basis to ensure the safety of drug use. The degree of perfection of ADR monitoring system and the implementation of monitoring directly affect the quality of drug safety monitoring. Institutions are the main places where patients are directly confronted with the use of drugs. The degree of attention paid by medical institutions to the monitoring of adverse drug reactions is the main factor affecting the safety monitoring of drugs, thus affecting the safe use of drugs in the human body. In this paper, 20 medical institutions in Sichuan region are selected, and the establishment, staffing, office space, office equipment, monitoring network system, monitoring staff training of these 20 medical institutions are discussed. The establishment of the corresponding system in the course of monitoring work was investigated by questionnaire, and the data on the quality of personnel, facilities, hardware and software were collected in the monitoring work of adverse drug reactions of medical institutions in Sichuan area of our country. The investigation and analysis showed that the monitoring of ADR and the corresponding software and hardware equipping rate of 20 medical institutions were between 35% and 50%. The full-time staffing rate is 35%, the personnel training system establishment rate is 30%, the establishment rate of adverse drug reaction monitoring assessment system is 20%. The registration rate in the national adverse drug reaction monitoring system accounts for 70%. The rate of good reaction / incident case report is 70%. Third Class A Hospital monitors, The equipment and system are better than the second class hospital, but most hospitals have not set up a system to deal with death, serious, mass occurrence and unexpected adverse events. Once a major ADR occurs, there may be serious drug safety hidden trouble. According to the actual situation of the medical institution and the literature, this paper holds that the medical institution should establish the comprehensive ADR monitoring system, especially the establishment of the ADR monitoring system of the basic medical institution. A complete set of adverse drug reaction monitoring institutions to ensure the normal development of ADR monitoring system and ADR monitoring database). In the specific ADR monitoring work, the medical staff should be trained in the systematic ADR reporting process and reporting methods, and the awareness of the close connection between the adverse reaction monitoring and reporting of medical personnel and the promotion of rational use of drugs and the safety of clinical medical treatment should be established. To train professionals and clinical pharmacists who are responsible for communicating drug information with clinical departments, to alleviate the concern of medical institutions in reporting ADR, to increase the financial input for ADR monitoring, to strengthen medical personnel's knowledge of drug use, and to focus on key departments. We should pay attention to the monitoring of ADR among key people, participate in the discussion of difficult or death cases, monitor some kinds of drugs susceptible to ADR, guide patients to use drugs carefully, and give full play to the role of nursing staff in ADR monitoring, so as to improve the quality of ADR monitoring.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R95

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本文編號(hào)：1656065