美国医院药师2015工作目标

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Complex or high-risk drug regimens are those that are particularly subject to potential danger or hazard:e.g. challenging dosing schedules or routes of administration, medications with documented and significant drug interactions, polypharmacy, and medications with a narrow therapeutic index, insulin,antithrombotics, chemotherapy, etc.
美国医院药学工作目标 与 培训战略
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美国医院药学工作目标


ASHP颁布（2003年），持续修改。 目的：确保患者用药安全有效。 作法：药师直接为患者提供药学服务，并作为 药学工作质量的评价标准。 具体要求：

六个目标，31个基本点。
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六个目标 1. 药师应更多的参与住院患者的个体化给药治疗过 程，使住院病人达到最佳的药物治疗效果。 2. 药师更多的参与非住院患者个体化给药治疗过程， 使非住院患者达到最佳的药物治疗效果。

药师应更广泛的参与非住院患者个体化给 药治疗过程，使非住院患者达到最佳的药 物治疗效果。
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70%的医疗诊所，药师与卫生保健团队其它成 员合作，参与使用复杂、高危药物患者的药物 治疗方案的制定（参与给药方案制定） 。 95%的医疗诊所，药师应常规的对使用复杂、 高危药物患者进行用药指导（用药指导）。 对90%的家庭护理服务患者，药师与卫生保健 团队其它成员合作，参与使用复杂、高危药物 的患者的药物治疗方案制定（参与给药方案制 定（家庭护理服务）。 对90%需要长期使用护理设施的患者，药师与 卫生保健团队其它成员合作，参与使用复杂、 高危药物患者的药物治疗方案制定（参与给药 方案制定（长期使用护理设施）。
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Medication Therapy Management encompasses a broad range of professional activities and responsibilities within the licensed pharmacist’s, or other qualified health care provider's, scope of practice. These services include but are not limited to the following, according to the individual needs of the patient:





a. Performing or obtaining necessary assessments of the patient’s health status; b. Formulating a medication treatment plan; c. Selecting, initiating, modifying, or administering medication therapy; d. Monitoring and evaluating the patient’s response to therapy, including safety and effectiveness; e. Performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events; f. Documenting the care delivered and communicating essential information to the patient’s other primary care providers; g. Providing verbal education and training designed to enhance patient understanding and appropriate use of his/her medications; h. Providing information, support services and resources designed to enhance patient adherence with his/her therapeutic regimens; i. Coordinating and integrating medication therapy management services within the broader health care-management services being provided to the patient.
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90%的医院，在转移交叉的连续治疗期间，药师应作患 者的用药依丛性教育工作（用药依丛性）。
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Goal1:Increase the extent to which pharmacists help individual hospitalinpatients achieve the best use of medications. 1.1Pharmacists will be involved in managing the acquisition, upon admission, of medication histories for amajority of hospital inpatients with complex and high-risk medication regimens* in 75% of hospitals.
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药师应主动的提供循证医学证据，以完善药 物治疗方案。

在医疗机构中，药剂科应在促进安全用药方面发 挥更显著的作用，和更重要的角色。 5. 医疗机构应增强安全用药方面的技术保障。 6. 拓展医疗机构的药师群体从事社区卫生服务领域 的工作内容。 31个基本点（基本要求/具体要求）
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Goal 1 increase the extent to which pharmacists help individual hospital inpatients achieve the best use of medications.
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Goal 2 Increase the extent to which health-system pharmacists help individual non-hospitalized patients achieve the best use of medications. Objective2.1 In 70% of health systems providing clinic care, pharmacists will manage medication therapy for clinic patients with complex and high-risk medication regimens*, in collaboration with other members of the health-care team. Objective2.2 In 95% of health systems providing clinic care, pharmacists routinely counsel clinic patients with complex and high-risk medication regimens. Objective2.3 In 90% of home care services, pharmacists will manage medication therapy for patients with complex and high-risk medication regimens*, in collaboration with other members of the health-care team. Objective2.4 In 90% of long term care facilities, pharmacists will manage medication therapy for patients with complex and high-risk medication regimens*, in collaboration with other members of the health-care team.

注：复杂、高危药物治疗：是指那
些有潜在危害的、有明确药物相互 作用的、复方制剂、治疗窗窄的、 具有特殊给药途经的药物（如胰岛 素、抗凝剂、化疗药、地高辛、万 古霉素等）。
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药物治疗监护：包括的内容很宽泛，以执业药师职
责范围内的专业活动和其它经过认证的健康护理者 职责为核心内容。主要包括下列项目，但不限于此。
1.3In 90% of hospitals, pharmacists will manage medication therapy for inpatients with complex and high-risk medication regimens*, in collaboration with other members of the health-care team. 1.4Hospital inpatients discharged with complex and high-risk medication regimens* will receive dischargemedication counseling managed by a pharmacist in 75% of hospitals. 1.550% of recently hospitalized patients (or their caregivers*) will recall speaking with a pharmacist while in the hospital. 1.6In 90% of hospitals, pharmacists will ensure that effective medication reconciliation* occurs during transitions across the continuum of care.