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      关于谈述西药药房退药的原因及解决策略网站位置: >> 医药学论文 >> 生物药物论文 >> 浏览文章
      谈述西药药房退药的原因及解决策略

      论文导读:

      西药药房退药的原因及解决对策探析【摘要】近些年来,“就医难看病贵”的理由受到了人们的广泛关注,在实施医疗改革服务大众的同时,医疗机构面对着严峻的挑战。西药退药理由越来越突出,通过对医院西药退药情况的分析与研究,了解退药理由,针对实际情况,提出有效的解决策略,减少退药情况的发生。
        【关键词】西药药房;退药;理由;策略
        1004-4949(2014)09-0637-02
        药品是预防、诊断、治疗患者疾病,有目的调节人体机能的物质,也是一种特殊商品,与民众的健康以及生命安全有着密切的关系。在实际医疗实践中,因为药品的不良反应、处方差错、不合理用药、药品价格等因素,导致退药情况越来越多。本文主要分析西药药房退药理由,结合实际情况,提出有效的解决策略。
        1.西药药房退药理由分析
        1.1医务人员理由
        医务人员理由主要包括两点:①门诊、急诊科室医生工作强度大,接触患者时间较少,经;岷鍪佣曰颊咭酝∈返奈恃,导致在用药的时候,普遍存在着患者过敏、不适等情况。比如,给患者糖尿病的患者开具含糖量较高的颗粒剂。②一些药品名称较为相似,医生在开具处方的时候,普遍存在着差错现象,尤其是一些新毕业以及年老的医生;一些药品品种规格较为相近,导致医生混乱,进而开错处方;部分医生对用药禁忌了解不建全面,导致在开药的时候,存在着互相作用的情况,导致患者在知道冲突之后退药。
        1.2药物不良反应理由
        不良反应指的就是抗菌药物以及中药注射剂导致的一些药疹、过敏反应等症状,不良反应是导致患者退药的主要理由。大部分患者的不良反应程度较轻,如各种皮疹、恶心、呕吐、头痛等?狗缡┧让鹜、抗菌药甲硝唑等会引起恶心、呕吐等不良反应,一些生物制品如降依降钙素会引起皮疹、发热、胃肠道反应等不良反应症状[1]。在患者出现不良反应之后,就会停药,进而要求退药。
        1.3患者理由
        患者因为病情变化,需要住院治疗,剩余药品不再需要,就会退药。除此之外,患者并不了解自身的疾病情况,在阅读完药品说明书之后,认为医生开的药不符合自身病症,或者不信任医生,或者对说明书中罗列的不良反应过多而拒绝服药。部分患者因为不知道药品的通用名,导致出现重复开药的情况,而要求退药;褂幸恍┗颊咭蛭锰跫南拗,对医生开具的药品无法予以支付,进而退药。
        1.4其他理由
        药房药品库存信息管理系统不完善,药品有效期管理工作中存在着严重的人为缺陷,致使患者发现药品快到期之后进行退药。除此之外,部分医院使用电子处方,一般电子处方系统的默认时间为一天3次,如果不注意调整,就会是很多一天1次、一天2次的药品出现超量配送,进而出现退药的情况[2]。
        2.西药药房退药的解决策略
        2.1减少医务人员因素导致的退药情况
        2.1.1提高医生的综合素质
        全面提高医生的职业道德与责任心,强化用药的合理性与科学性,同时,坚持以患者为中心的服务理念,逐渐提升诊疗质量。强化医患之间的交流,在开具处方的时候,认真问询患者的病史、过敏史、用药史等;尽可能选择效价比较高的药品,降低患者的经济压力;挂忧慷砸缴囊滴衽嘌,不断丰富医生的药学知识,对药品的适应症、不良反应、禁忌、互相作用等进行全面的了解,详细告知患者,让患者有所准备;与此同时,强化对医生法律法规的培训,提高医生的严谨性与科学性,保证临床诊断和用药的一致,尽可能提高用药的安全性、经济性与科学性。除此之外,还要加强对医生信息化的培训,熟练掌握各种软件操作,避开出现不熟悉或者疏忽而开错处方的情况,减少退药。
        2.1.2提高药师的业务水平
        在日常工作中,一定要不断提高药师的业务素质,积累更多的新知识,增加药学理论知识,对各种药物的药理、适应症、不良反应、禁忌、互相作用等进行牢固掌握[3]。同时,加强药师对处方的审核,尤其是药品互相作用的时候,一定要避开出现用药错误或者搭配不合理的情况,及时告知处方医生,请求其更改。在进行药品调配的时候,主动解答患者的疑问,消除患者的顾虑,指导患者进行合理用药,减少退药。
        2.2减少患者因素导致的退药情况
        强化药师咨询服务的展开,为患者解答相关用药疑问。通过面对面的交流,向患者传递药物知识以及用药注意事项,并且详细讲解用药的副作用,保证患者具有知情权,这样可以有效提高患者的安全感与依从性,对减少退药现象有着积极作用。除此之外,还可以建立计算机咨询平台,让患者可以自行查阅相关药物的详细情况,进而为患者服药提供参考依据,帮助患者合理用药,减少了退药情况。
        2.3完善医院信息化系统
        在医院中构建完善的信息化系统,可以有效减少出现差错的几率,对减少医患矛盾有着重要作用。比如,在医生工作站中合理嵌入用药系统,对各种药品的互相作用、禁忌等情况进行提示,如果需要联合用药,并且存在互相作用关系,就可以红色警示。通过此项功能的运用,可以有效降低处方差错,提高医疗服务质量,进而减少退药情况。在开具一天1次、一天2次的药品时,一定要关闭一天3次或者其它的选项,防止出现因为疏忽导致超量处方的理由。除此之外,在药房药品库存信息管理系统中,一定要设置到期提醒功能,当某一药品还有3个月就要到期的时候,系统给予红色警示,这样就可以避开药品浪费,并且有效减少了医患矛盾,对减少退药现象有着积极作用[4]。
        3.结语
        总而言之,西药药房退药是一种普遍存在的现象,导致出现此种情况的理由有很多,可以采取相应的策略予以解决,减少退药现象,降低退药的负面影响。在实际工作中,一定要重视医生综合素质以及医师业务水平的提高,设置医师咨询窗口与计算机咨询平台,为患者提供更多的药物知识,完善医院信息化系统,进而减少退药现象。
        参考文献
        [1]廖群仙,梁伟泽,谢燕萍,等.366例门诊西药房退药理由分析及解决策略[J].医学信息(上旬刊),2011,24(08):5231-5232.
        [2]张晓峰,刘玉平.我院门诊退药理由分析及策略研究[J].中国当代医药,2012,19(24):161-162.
        [3]陈睿,钟兴继.医院门诊西药房退药分析及应对措施[J].医药前沿,2012,02(04):366-366.
        [4]刘全峰.门诊西药房退药处方情况分析及解决策略[J].中国药事,2009,23(07):721-722. 全文地址:http://www.abcanuncios.com/swywlw/lw50498.html
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