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1、对临床药学焦点问题的认识,邵 宏 北京大学药学院药事管理与临床药学系,ACCP (American College of Clinical Pharmacy). , 2008,主要焦点问题,如何理解临床药学和药师的内涵？,何为临床药学？ Clinical Pharmacy,临床(clinical)的概念 【美国传统词典】Involving or based on direct observation of the patient 【高级汉语词典】接触病人，诊治疾病 ACCP和ESCP的权威定义 形式 药学实践(Pharmacy Practice) Clinical Pharmacy is a
2、commonly used term in pharmacy practice and in pharmacy literature 核心 合理用药 the activities and services of the clinical pharmacist to develop and promote the rational and appropriate use of medicinal products and devices 使命与患者基本需求 药学监护(Pharmaceutical Care) necessary philosophy and mission of pharmacy
3、 practice, a basic patient need 历史地位：Revolution or Renaissance ? 临床药学是医疗发展的必然结果,先进 (美国),发达 (欧澳日),发展中 (中国),初期,落后,药师职业与国家临床药学水平,美国药学院校教学重心转移,何为临床药师？ Clinical Pharmacist,临床药师是为患者提供药学服务的药学专家（Pharmacy Specialist） 美国药学人员的分类 Pharmacist (Pharmacy specialist, Clinical Pharmacist) Pharmacy technician 临床药师相关问题
4、 Part or Full ？ FTE Pharmacists (Full Time Equivalent，40 hrs/w) 临床药师的数量、学位和社会地位,临床药师的数量,临床药师的学位,MONEY Magazine 2006 Career Survey,Pharmacists 9/50 Stress: B Flexibility: C Creativity: B Difficulty: C Ten Year Growth: 24.5% Average Pay: $91,988,主要焦点问题,如何理解临床药学和药师的内涵？ 临床药师为谁而工作？如何工作？,工作对象： 医生 or 患者？,工
5、作环境： 个人 or 群体？,Physicians Attending Fellow Resident Intern Medical student Physician assistant 56:1981-7,Total Pharmacy Care (TPC),工作的主要内容,对医务人员和病人及其家属进行教育，讲座与宣传等,Scholarly Activities,理论课学习,Scholarly Activities,科学研究,工作的主要内容,对医务人员和病人及其家属进行教育，讲座与宣传等,Points of Pharmacy Practice,查房前更新药历 Patient Profile
6、28(11):3747 南加州大学；新墨西哥州大学,每个等级都包含了4个方面的活动： clinical, educational, administrative, scholarly,2006年美国临床药师工作状况,MacLaren R, Rudis MI, et al. Ann Pharmacother 2006; 40:612-8 科罗拉多州大学；南加州大学 382个医疗机构,主要焦点问题,如何理解临床药学和药师的内涵？ 临床药师为谁而工作？如何工作？ 临床药师主要干什么？ 临床药师都在哪里工作？ 临床药师的水平如何分出高下？ 如何保持和提高临床药学工作水平？,职业培训与继续教育 Cont
7、inuing Education,普通药师,临床药学专业毕业生,美国药师岗位培训Residency,Job (practice) Residency (10%) PhD,PharmD,Pharmacist Academic Teacher & Researcher Pharmacy technician (No License),PGY1 (普通培训) PGY2 (专科培训),Licensed Pharmacist,Board certification （有效期6年）,BCPS BCOP BCPP BCNSP BCNP,Hospital Retail stores (60%) Drug Co
8、mpany Government,50%,组织结构,Advisor,Preceptor,Resident,Instructor,Residency Executive Committee,Resident Program Director,Chief Resident,Beginning, Quarterly, Exit,Monthly or Daily,Daily,Conclusion,测试与评估,Residency Protest for Pharmacokinetics,转科,职业培训的评估内容,主要焦点问题,如何理解临床药学和药师的内涵？ 临床药师为谁而工作？如何工作？ 临床药师主要干
9、什么？ 临床药师都在哪里工作？ 临床药师的水平如何分出高下？ 如何保持和提高临床药学工作水平？ 行业协会能为临床药学做些什么？,行业协会与药师的认证评估,APhA American Pharmacist Association (1852) NARD National Association of Retail Druggists (1898) NABP National Association of Boards of Pharmacy (1904) ACPE Accreditation Council for Pharmacy Education (1932) AACP American
10、Association of Colleges of Pharmacy (1937) ASHP American Society of Health-System Pharmacists (1942) ASCP American Society of Consultant Pharmacists (1969) ACCP American College of Clinical Pharmacy (1979) AAPS American Association of Pharmaceutical Scientists (1986) NISPC The National Institute for
11、 Standards in Pharmacist Credentialing (1998) ESCP European Society of Clinical Pharmacy,The Board of Pharmaceutical Specialties (B.P.S.) 1976 Nuclear Pharmacy (1978) BCNP Nutrition Support Pharmacy (1988) BCNSP Pharmacotherapy (1988) BCPS Psychiatric Pharmacy (1992) BCPP Oncology Pharmacy (1996) BC
12、OP,The Commission for Certification in Geriatric Pharmacy (C.G.P.) 1997,Certified Disease Manager (C.D.M.) of diabetes, asthma, dyslipidemia, and anticoagulation therapy.,美国药师继续教育规范,Help individual hospital inpatients and nonhospitalized patients achieve the best use of medications. Apply evidence-based methods to the improvement of medication therapy. Improving the safety of medication use. Apply technology effectively to improve the safety of medication use. Engage in public health initiatives on behalf of their communities.,Thank you !,Any Questions ?,66,
