四川地区部分医疗机构不良反应监测现状的调查分析及建议

发布时间：2018-03-24 01:19

本文选题：药品不良反应　切入点：医疗机构　出处：《成都中医药大学》2014年硕士论文

【摘要】：随着医药工业的发展,药品的安全性日益受到广泛关注。药品不良反应(Adverse drug reactions, ADR)监测工作也逐步向规范化、科学化方向发展。药药品不良反应监测是保证患者安全用药的基础。药品不良反应监测体系完善程度及监测工作实施力度直接影响药品安全性监测的质量。医疗机构是直接面对患者使用药品的主要场所,医疗机构对药品不良反应监测的重视程度是影响药品安全性监测的主要因素,从而影响到人体的安全用药。本文选取四川地区20家医疗机构,对该20家医疗机构药品不良反应监测机构的设立、人员配备、办公场所、办公设备、监测网络系统、监测人员培训、监测工作开展过程中相应制度的建立情况等进行问卷调查分析,收集我国四川地区医疗机构药品不良反应监测工作中关于人员素质、设施配备等软、硬件等方面的数据。调查分析显示20家医疗机构对ADR的监测及相应的软件及硬件配备率都在35%-50%之间,未占半数。专职人员配备率为35%,人员培训制度建立率为30%、药品不良反应监测工作考核制度的建立率为20%。在国家药品不良反应监测系统中注册率占70%,填报《药品不良反应／事件病例报告表》率占70%。三甲医院在监测人员、设备配备、制度建立等方面较好于二甲医院,但大多数医院都对死亡、严重、群发、突发不良事件的应对制度未建立,一但发生重大ADR将可能产生严重药品安全隐患。本文针对医疗机构的实际情况,结合文献,认为医疗机构应建立全面的ADR监测系统,特别是基础医疗机构的ADR监测系统的建立(建立药品良反应监测体系、配套的药品不良反应监机构、保证ADR监测工作正常开展的制度、ADR监测数据库) 在具体的ADR监测工作中应对医务人员进行系统的ADR的上报流程和上报方法的培训、树立医务人员不良反应监测报与促进合理用药及临床医疗安全紧密联系的意识、培养负责专门将药物信息与临床科室相互沟通的专业人员、临床药师、减轻医疗机构上报ADR的顾虑、增加ADR监测的经费投入、加强医务人员的用药知识、集中重点科室、关注重点人群进行ADR监测、参加疑难或死亡病例讨论、重点监测某些易发ADR的药品品种、细心指导患者用药、充分发挥护理人员在ADR监测中的作用,以提高ADR监测工作的质量。
[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.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R95

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