College of Pharmacy, University of Arizona, AZ, USA.
Am J Health Syst Pharm. 2010 Apr 1;67(7):542-58. doi: 10.2146/ajhp090596.
Results of the 2009 ASHP national survey of pharmacy practice in hospital settings that pertain to monitoring and patient education are presented.
A stratified random sample of pharmacy directors at 1364 general and children's medical-surgical hospitals in the United States were surveyed by mail. SDI Health supplied data on hospital characteristics; the survey sample was drawn from SDI's hospital database.
The response rate was 40.5%. Virtually all hospitals (97.3%) had pharmacists regularly monitor medication therapy in some capacity; nearly half monitored 75% or more of their patients. Over 92% had pharmacists routinely monitor serum medication concentrations or their surrogate markers, and most hospitals allowed pharmacists to order initial serum concentrations (80.1%) and adjust dosages (79.2%). Interdisciplinary committees reviewed adverse drug events in 89.3% of hospitals. Prospective analysis was conducted by 66.2% of hospitals, and retrospective analysis was performed by 73.6%. An assessment of safety culture had been conducted by 62.8% of hospitals. Most hospitals assigned oversight for patient medication education to nursing (89.0%), but many hospitals (68.9%) reported that pharmacists provided medication education to 1-25% of patients. Computerized prescriber-order-entry systems with clinical decision support were in place in 15.4%, bar-code-assisted medication administration systems were used by 27.9%, smart infusion pumps were used in 56.2%, and complete electronic medical record systems were in place in 8.8% of hospitals. The majority of hospitals (64.7%) used an integrated pharmacy practice model using clinical generalists.
Pharmacists were significantly involved in monitoring medication therapy. Pharmacists were less involved in medication education activities. Technologies to improve the use of medications were used in an increasing percentage of hospitals. Hospital pharmacy practice was increasingly integrated, with pharmacists having both distribution and clinical roles.
呈现 2009 年 ASHP 针对医院环境中药学实践的全国调查结果，这些结果涉及监测和患者教育。
通过邮件对美国 1364 家综合和儿童外科医院的药剂主任进行分层随机抽样调查。SDI Health 提供了有关医院特征的数据；调查样本取自 SDI 的医院数据库。
回复率为 40.5%。几乎所有医院（97.3%）都有药剂师以某种形式定期监测药物治疗；近一半的医院监测了 75%或更多的患者。超过 92%的医院让药剂师常规监测血清药物浓度或其替代标志物，大多数医院允许药剂师开初始血清浓度（80.1%）和调整剂量（79.2%）。89.3%的医院设有跨学科委员会审查药物不良事件。66.2%的医院进行前瞻性分析，73.6%的医院进行回顾性分析。62.8%的医院进行了安全文化评估。大多数医院（89.0%）将患者用药教育的监督职责分配给护理部门，但许多医院（68.9%）报告说，药剂师为 1-25%的患者提供用药教育。只有 15.4%的医院配备了带临床决策支持的计算机化医嘱录入系统，27.9%的医院使用了条码辅助用药管理系统，56.2%的医院使用了智能输液泵，8.8%的医院配备了完整的电子病历系统。大多数医院（64.7%）采用了使用临床通才的综合药学实践模式。
药剂师在监测药物治疗方面发挥了重要作用。药剂师在用药教育活动中的参与度较低。越来越多的医院采用了提高药物使用效率的技术。医院药学实践日益整合，药剂师兼具配药和临床角色。
