Kootsikas M E, Hayes G, Thompson J F, Perlman S, Brinkman J H
Pharmacy Service, Department of Veterans Affairs Outpatient Clinic, Los Angeles (VAOPCLA), CA 90013.
Am J Hosp Pharm. 1990 Nov;47(11):2478-82.
The involvement of a clinical pharmacist in a Department of Veterans Affairs seizure clinic is described. A pharmacist who had served a residency in ambulatory care began working in a seizure clinic in 1988 after obtaining the cooperation of a neurologist interested in a multidisciplinary approach to patient care. A clinical protocol was developed to guide the pharmacist's participation. The seizure clinic is staffed by the clinical pharmacist, a pharmacy resident, and a neurologist and is currently treating 162 adult male veterans. Of the 162 patients, 159 are receiving anti-convulsant therapy. The role of the pharmacist is to assist the neurologist in providing patient-care services. The pharmacist interviews each patient, performs a neurological assessment and mental status evaluation, and orders laboratory tests. Information is recorded by the pharmacist on a history form and a subjective and objective assessment and planning form. The pharmacist presents the findings to the neurologist, and the patient is then interviewed jointly by the pharmacist and the neurologist. Between appointments, the pharmacist follows up on abnormal laboratory test values and informs patients of any necessary dosage adjustments. More time is available for patient care, there has been an increase in the detection of adverse drug reactions and disease states, and record keeping has improved. A pharmacist assumed a primary-care role in a seizure clinic by interviewing and assessing patients, ordering laboratory tests, and participating in the selection and adjustment of anticonvulsant therapy.
本文描述了一名临床药剂师在退伍军人事务部癫痫诊所的工作情况。一名完成门诊护理住院实习的药剂师，在获得一位对患者护理多学科方法感兴趣的神经科医生的合作后，于1988年开始在癫痫诊所工作。制定了一项临床方案以指导药剂师的参与。癫痫诊所的工作人员包括临床药剂师、药学住院医师和神经科医生，目前正在治疗162名成年男性退伍军人。在这162名患者中，159名正在接受抗惊厥治疗。药剂师的职责是协助神经科医生提供患者护理服务。药剂师会对每位患者进行访谈，进行神经学评估和精神状态评估，并安排实验室检查。药剂师将信息记录在病史表格以及主观和客观评估与计划表格上。药剂师将检查结果告知神经科医生，然后药剂师和神经科医生会共同对患者进行访谈。在预约就诊期间，药剂师会跟进异常的实验室检查值，并告知患者任何必要的剂量调整。有更多时间用于患者护理，药物不良反应和疾病状态的检测有所增加，并且记录保存也得到了改善。一名药剂师通过对患者进行访谈和评估、安排实验室检查以及参与抗惊厥治疗的选择和调整，在癫痫诊所中承担了初级护理的角色。
