儿科门急诊药房用药指导现状与患者需求调研  

Investigation on Current Situation of Medication Guidance and Patients’Needs in Pediatric Outpatient and Emergency Pharmacy

作　　者：牛振喜[1] 贾运涛[2] 王晓玲 马姝丽 李超 孙燕燕[4] Niu Zhenxi;Jia Yuntao;Wang Xiaoling;Ma Shuli;Li Chao;Sun Yanyan(Children’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450018,China;Children’s Hospital of Chongqing Medical University,Chongqing 400014,China;Clinical Research Center,National Children’s Medical Center/Beijing Children’s Hospital,Capital Medical University,Beijing 100045,China;Tianjin Children’s Hospital,Tianjin 300074,China)

机构地区：[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

出　　处：《儿科药学杂志》2024年第9期17-24,共8页Journal of Pediatric Pharmacy

基　　金：河南省医学科技攻关联合共建项目,编号LHGJ20220768。

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。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

关 键 词：儿科 门急诊药房 用药指导 需求与现状 

分 类 号：R95[医药卫生—药学]