Study On The Dynamics And Resistance In The Implementation Of The Clinical Pharmacist Policy In China

Object:In order to adapt the developing of the world pharmacy care,to promote safe,economic,rational clinical use of drugs,perfect medicine care,change the used of the negative function of the pharmacy.The study of the dynamics and resistance in the implementation of clinical pharmaceutical in china in this paper,will be good to the policy improvement and extension in the future.Data and Methods:Theoretical research is the mainly method in the data collection,data reduction and data analysis,and the investigation play an assisted function in the study.Data collection method literature method:through library,internet to search books,journals,electronic resource,learn more about clinical pharmaceutical care,clinical pharmaceutical policy in or out of china and the data of the situation of the policy implementation.Mainly collect the cases and the experience data. Field survey:this study investigate 10 hospitals,20 doctors,20 nurses and 30 pharmacists in total,half of the hospitals,doctors,nurses,pharmacists are in Wuhan,and the other half are in Shenzhen.The interview,e-mail,and telephone are used in this investigation to get some data about whether the clinic pharmacist policy were implemented,the responsibility of the pharmacists,the situation of the policy implementation,the condition of the policy implementation and the suggestions,the resistance may be come across during the policy implementation and the analysis of the source.Data analysis method mainly used literature method,include case analysis,interest group analysis,SWOT analysis and so on.Results and Conclusions:The study was base on the theory,practice and the distance of the implementation of the clinical pharmacist policy domestic and overseas,and the significant cases.And it conclude the main dynamic and resistant factors in the implementation of the clinical pharmacists policy,especially in:1.Dynamic analysis:China has a very strong theory basis in the implementation of the clinical pharmacists policy.The concept such as the seven star pharmacists,pharmaceutical care evidence-based pharmacy,self-medication were proposed,the core idea is:take the patients as the centre of the medicine,the pharmacists provide the pharmaceutical care to the medical staff,patients and their families,ensure the safety,effectiveness and economic use of drugs. There is abundant of data in the clinical pharmacists policy practice.The united medicine research developing centre proposed and passed"the regulation of the training of the comprehensive medicine staff"of America in 1970.Ensure the clinical practice of the pharmacy students;The new standard was promulgated by the committee in 1974,Pharm.D.degree must have being 1500 hours training of"clinical pharmacy intern students";The standard of clinical pharmacy specific was widely implemented,such as how many times they do clinical work every week,which departments they mainly work in,what they always do specifically and so on.Some hospitals in china have get much more from the training of the clinical pharmacy and their work development,which based on the learning of the developed practice abroad,and then take them in,so to be a good example to the next work of china.In the investigation,there have been 42 clinical pharmacists training pilots in the present in china,each pilot develop the work combines to self characteristics,such as adverse reaction monitoring,therapeutic drug monitoring,rounds by clinical pharmacists,direction of medication usage,though it has not been standard,spread even road for the implementation of the clinical pharmacist policy.We still have a long distance on the theory and practice of clinical pharmacy policy with many developed country.The policy developed very slow in china even though it started quite early,the concept such as seven star pharmacist,pharmaceutical care,self-medicine were provided overseas,but there are few were proposed in china;Clinical pharmacy care education was standardized by the way of law in America as early as 1963,but it was only mentioned in the department rule till now in china;The Pharm.D.degree were widely implemented in America from 2000,but there are only 42 training pilots here in china today,and so on.We still have a long way to go,we have to work hard so as to catch the high level of the world.The clinical pharmacy care implementation can improve the qualification of the medical care effectively.The important work of the clinical pharmacists include:clinical work,therapeutic drug monitoring,adverse drug reaction monitoring and so on,the pharmacy must be a supplement and monitoring to the prescription behavior,perfect this policy not only can decrease the medical cost,but also can regulate the medical care and promote rational drug used,make the medical care quality improved more rational.In the investigation,the medicine staff of the pilots have a good evaluation to the clinical pharmacists policy,the nurse especially believe that the pharmacists give then much help in drug usage,and they have many cases,other objects of the investigation holds that the implementation of the policy will improve the quality of the medicine care greatly. The significant cases in china that implemented the clinical pharmacist policy will be the guide of the work.Even though there are few hospitals pushed the policy as hard as Changhai hospital in china,they must be a good guidance to the future work.They accumulate so much experience in the clinical pharmacist training and the clinical work and so on,they made the policy well implemented in china quite possible.2.Resistant analysisThe extent of the clinical pharmacist policy related law guarantee is not enough.《Temporary Regulations of Pharmacy Affairs for Medical Institutions》just a department rule,the function is quite limited,and the content is simple,it hindered the policy developing in china in some extent.It is find in the investigation that:the absent or not enough of the law guarantee can hardly implement the policy in the whole china.The only two pilots in the sis highest cent hospitals set the professional post of the clinical pharmacists,the other four let the normal pharmacists work in some clinical pharmacy work,such as adverse reaction monitoring,but the work such as ward around has already not being develop.The traditional training and management system are not adapt to the implementation of the clinical pharmacist policy.Paying too much attention to training the model of economic development,and look down upon the model of pharmaceutical care,the education is far away from the real clinic,neglect clinic drug therapy,and the of the training of rational drug used;Pharmacy education still take more importance in chemistry.The training object and the curriculum are not adapt to the responsibility that given by the medicine care further development.This problem reflect more in this investigation,the hospital managers hold that the most resistance is the multiple management make the policy differently, the work can't develop normally;the pharmacists have nor been educated and trained further,the curriculum they accept in the university mainly consist of the chemistry,the clinical pharmacists can't adapt to the clinical pharmacy work,they must have been trained further in the hospital.The policy may threaten the traditional medical concept.The traditional idea such as"the pharmacist is the man who sent the drug",mistake the pharmacist to salesman,make the patient distrust the pharmacist;many pharmacists are satisfy to the recent work in the pharmacy and don't accept renewal their knowledge,they can't provide useful advice to the doctor and the nurse in a high level,these all lower the development of the pharmaceutical care in the beginning.It is showed in the investigation that the doctor evaluate highly to the clinical pharmacist policy implementation,but when there is something affect their safety and habitation,they always express resistant emotion,it may suffered by the nurse and the new clinical pharmacists,and affect the implementation of the clinical pharmacist policy indirectly.SuggestionMake full use of the dynamic factors to implement the clinical pharmacist policy effectively and quality.Improve the level of the law guarantee.Set up the new pharmacy education system and management system to adapt to the clinical pharmacist policy development.Make clear the position of the clinical pharmacist,build up good reputation,change the traditional concept of the authority and medicine step by step.