“1+X”网格化模式在审方药师药学服务胜任力培养中的应用和实践  

Application and practice of'1+X'grid mode in pharmaceutical care competency training of prescription-checking pharmacists

作　　者：马旖旎[1,3] 张哲弢 邓晓媚 张理想 张瑾 史天陆[1,3] MA Yini;ZHANG Zhetao;DENG Xiaomei;ZHANG Lixiang;ZHANG Jin;SHI Tianlu(Department of Pharmacy,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230001,China;Internal Medicine-Cardiovascular Department,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230001,China;Anhui Provincial Key Laboratory of Precision Pharmaceu-tical Preparations and Clinical Pharmacy,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)药学部,安徽合肥230001 [2]中国科学技术大学附属第一医院(安徽省立医院)心血管内科,安徽合肥230001 [3]精准药物制剂与临床药学安徽省重点实验室,安徽合肥230001

出　　处：《安徽医药》2025年第1期200-205,共6页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省教育厅高等学校省级质量工程项目(2021jyxm1800)。

摘　　要：目的通过建立规范、系统、可行的培训方法和课程体系,探索以临床药师为核心的审方药师培养与实践新模式,为各级医疗机构处方审核药师培训考核机制建设提供参考。方法从专业、团队、工作三个层面构建“1+X”网格化处方审核药师培养模式,利用合理用药分析软件,分析评价中国科学技术大学附属第一医院2022年1—10月“1+X”处方审核模式应用效果;并采用李克特量表,设定审方药师自我评价满意度水平,据此设计问卷调查表,进行审方药师培训前后药学服务胜任力的自我评定。结果经过“1+X”网格化模式培训后,审方药师已成功优化审方规则225条,药师每月审核处方比例从5.24%降至2.56%,药师每月干预处方比例从19.32%降至11.17%,医师修改处方数、药师干预有效的处方数、整体用药错误上报率等明显下降,审方工作效率提升;审方药师在个人素养、基本知识和技能、专业知识和技能、内驱力方面均得到了不同程度的提升(P<0.05)。结论“1+X”工作模式应用效果显著、易推广,可提高药师核心胜任力,保障用药安全,契合当前政策和实际工作的需要。Objective To explore a new model of training and practice of prescription-checking pharmacists with clinical pharmacists as the core by establishing standardized,systematic,and feasible training methods and curriculum systems,and to provide references for the construction of training and examination mechanisms for prescription-checking pharmacists at all levels of healthcare institutions.Methods The"1+X"grid prescription-checking pharmacists training mode was constructed from the three levels of specialty,team,and work.Rational drug use analysis software was used to analyze and evaluate the application effect of"1+X"prescription-checking mode from January to October 2022 at The First Affiliated Hospital of University of Science and Technology of China,and the Likert scale was used to set the self-evaluation satisfaction level of prescription-checking pharmacists.Based on this,a questionnaire was designed to assess pharmaceutical care competence before and after training.Results Following training in the"1+X"grid model,prescription-checking pharmacists effectively optimized 225 prescription-checking rules.Consequently,the proportion of monthly prescriptions checked by pharmacists decreased from 5.24%to 2.56%,and the proportion of monthly prescriptions intervened by pharmacists decreased from 19.32%to 11.17%,meanwhile,there was a significant reduction in the number of physician-modified prescriptions,pharmacist-intervened prescriptions,and the overall medication error reporting rate,all of which enhanced the efficiency of prescription-checking work.Prescription-checking pharmacists had achieved varying degrees of improvement in their personal qualities,basic knowledge and skills,professional knowledge and skills,and internal drive(P<0.05).Conclusion The application effect of"1+X"working mode is remarkable and easy to popularize,which can improve the core competence of pharmacists,ensure medication safety,and meet the needs of current policies and practical work.

关 键 词：胜任力 处方审核 药师培养 “1+X”模式 临床药师 

分 类 号：R95[医药卫生—药学]