癌癥臨床藥事照護與?？扑帋熑瞬排嘤?xùn)

癌癥臨床藥事照護與

?？扑帋熑瞬排嘤?xùn)目錄1.藥事照護如何在xx生根?2.藥事照護藥師的重要性3.專科藥師人才培育與認證4.癌癥藥事照護在xx的重要性5.預(yù)備癌癥藥事照護在xx臨床(clinical)與遞送(distributional)互相獨立又互相互補Distributional：確保到達病人的實體產(chǎn)品是正確的認明藥品處方與用藥指示制作藥品標簽制備藥品于適當?shù)娜萜髦忻绹鴷?：這些功能不需要藥師的臨床知識與技能不能確保病人真正得到藥品的裨益*IntroductiontoHospitalandHealth-SystemPharmacyPractice.

ASHP,

2010臨床(clinical)與遞送(distributional)美國書*2010年出版評估「在出院時與發(fā)藥時，完整的病人用藥咨詢服務(wù)」確定可以提升病人藥物治療結(jié)果不幸的是，這樣的服務(wù)不要說完整的，連簡短的用藥指導(dǎo)并沒有一致性地提供給病人Problemwiththecurrentdispensingprocesses-pharmacistsarenotprovidingevenminimaldiscussionsthatpatientsmayneedaboutmedicationsIn1981,RussellMiller:這種以調(diào)劑為導(dǎo)向的服務(wù)已經(jīng)造成許多藥師的挫折，他們完成5年或更長教育的只為了進入沒有要求(undemanding)，不具專業(yè)的(unprofessional)執(zhí)業(yè)型態(tài)。*IntroductiontoHospitalandHealth-SystemPharmacyPractice.

ASHP,

2010臨床(clinical)與遞送(distributional)遞送功能必須交給科技(自動化)藥學(xué)專業(yè)必須全面向臨床功能轉(zhuǎn)型處方的判讀需要臨床功能病人用藥教育需要臨床功能調(diào)劑與遞送功能有臨床功能的加入可以更加有效藥學(xué)畢業(yè)生越來越深入的訓(xùn)練無法被只限制在藥品調(diào)劑服務(wù)Itishardtojustifytoemployersthehighsalariesofpharmacists,iftheyareunderemployedinroutinedispensingtasks**IntroductiontoHospitalandHealth-SystemPharmacyPractice.

ASHP,

2010臨床藥事照護的重要性臨床病人照護是藥事服務(wù)(行政、藥業(yè)、研究、法規(guī)等)的起點一切的藥事服務(wù)都以病人的福祉為中心臨床病人照護的中心則是在直接病人照護(directpatientcare)沒有直接病人照護，就沒有臨床藥學(xué)的發(fā)展不是為了提升藥師的地位，而是為了維護病人用藥權(quán)益臨床藥事照護的重要性甚么是病人用藥權(quán)益?藥師不懂用藥如何幫助病人與醫(yī)療團隊用藥藥師只懂?？朴盟幦绾螏椭∪伺c醫(yī)療團隊沒有類似醫(yī)師從見習醫(yī)師(intern/clerk)到住院醫(yī)師(resident)到主治醫(yī)師(attending)的學(xué)習，病人為何要讓藥師來管理他的用藥?中心議題：

誰有資格照顧病人用藥?Clinicalknowledge(education)vs.

ClinicalExperience(training)ClinicalExperienceClinicalKnowledgeClinicalknowledgevs.

ClinicalExperienceKnowledgemainlyisgainedbyreading/discussioninpharmacotherapyclassPharmD:24credithoursBS+MS:8-12credithoursExperiencemainlyisgainedbydoingThebestsequence:goodknowledge→goodexperiencePharmD(knowledge)followedbyresidency(experience)NoteveryPharmDgraduatehasgoodfoundationofknowledge(readingwithoutdoingtendstobeforgetful)臨床藥事照護沒有進階學(xué)位國家規(guī)定最基礎(chǔ)可以參加國家考試的學(xué)位有藥師執(zhí)照以后開始累積臨床經(jīng)驗沒有一個進階學(xué)位可以確保合格的臨床藥師(臨床研究有學(xué)位)沒有捷徑，累積經(jīng)驗是唯一的路徑如何累積經(jīng)驗是關(guān)鍵足夠時間與廣度有訓(xùn)練目標與架構(gòu)有確實的評估CompetenceTheskills,attitudes,andotherattributes(includingvaluesandbeliefs)attainedbyanindividualbasedonknowledge(gainedthroughstudyatuniversity)andexperience(gainedthroughsubsequentpractice)whichtogetherenabletheindividualtopracticeeffectivelyasapharmacist.NationalcompetencystandardsframeworkforpharmacistsinAustralia2010Entry-level/Residency/SpecializationCompetencyFrameworkPharmacyEducationtowardDPC:

USvs.TWUSPharmDTWPharmDTWB.S.6years(2+4)6years4yearsMS2yearsNewRPhtraining2yearsPGY1

(gen.residency)?(1yeartraditional)?(1yeartraditional)PGY2(spec.residency)?(1yeargen.residency)?(1yeargen.residency)Specialtyrecognition?(1yearspec.residency)?(1yearspec.residency)?(Specialtyrecognition)?(Specialtyrecognition)DPC=directpatientcareWhyWeWanttoStartResidencies?CurrentTaiwanese4-yeargraduatepharmacistsneedsystematicwaystogainclinicalknowledgeandexperienceforcaringpatientsGainingclinicalknowledgeiseasierthancumulatingclinicalexperience>>>residencyisthewaytocumulatestructuredclinicalexperienceefficientlyWeneedboth4-year&6-yeargraduatescomingforourpatientcareservices通科住院藥師

訓(xùn)練計劃手冊

完成!WhyWeNeedSpecialtyRecognition?FactorsattributedtopharmacypracticedifferentiationRapiddevelopmentofnewdrugsanddrugdeliverysystemsChangesinthehealthcaredeliverysystemAnincreaseinacuityofillnessofinstitutionalizedpatientsIncreasedemphasisonpatientoutcomesandqualityofhealthcareTherapidproliferationofdruginformationWhyWeNeedSpecialtyRecognition?TruespecializationinpharmacyisbasedonauniquecoreofscientificknowledgeandpracticeskillsSpecializationisanindicatorofprofessionalmaturityandgrowthPurposesIntendedtoassurethepublicthatpharmacyspecialisthasattainedahighlevelofcompetenceandskillInformotherprofessionalcolleaguesthatapatientreferredtothespecialistwillbecompletelyservedWhyWeNeedSpecialtyRecognition?CertificateprogramAtypeofcontinuingeducationprogramIn-depthprogramonaspecifictopiccommonlyencounterinpharmacypracticeCertificateprogramsdonotassesscompetencyorexpertiseinthatareaPharmacycertificationvsmultidisciplinarycertificationsCertifiedanticoagulantcareprovider(CACP)CertifiedDiabetesEducator(CDE)WhyWeNeedSpecialtyRecognition?Finalgoal:Toprotectpatientsfromunqualifiedpharmacistsprovidingunsoundpharmaceuticalcare.ToprovideaffordablecertificationprogramforTaiwanesepharmacists.Transitionalgoal:ForBS:obtaintheUSspecialtyrecognition(esp.BCPS)tomakesurethepharmacotherapeuticknowledgeisqualified,thenparticipateresidencyinTaiwantoobtainastructuredclinicalexperience.ForPharmD:demonstrateyourqualificationafteryour6-yearstudyandgeneral/specialtyresidencyCompetenceCheckSpecialization/Credentialing/PrivilegingCredentialingisaprocessthatdocumentstheattainmentofqualificationstoprovideascopeofcareexpectedPrivilegingisaprocesstoassurecompetenciesandexperiencesforspecificservicesinanorganization?？扑帋焩s.?？谱o理師比較項目?？谱o理師?？扑帋熌康淖尡唤桓兜尼t(yī)療行為合法化，保護護理師不違法。讓病人得到更好的用藥照護服務(wù)范圍有限的，當要增加服務(wù)項目，他們要確定適法性。沒有范圍限制，醫(yī)療團隊有更多的需求，我們樂意配合訓(xùn)練有學(xué)位可以讀沒有學(xué)位可以讀，也沒有某一個明確的訓(xùn)練癌癥?？扑帋煹谋匾园┌Y專科符合上面所提因素RapiddevelopmentofnewdrugsanddrugdeliverysystemsChangesinthehealthcaredeliverysystemAnincreaseinacuityofillnessofinstitutionalizedpatientsIncreasedemphasisonpatientoutcomesandqualityofhealthcareTherapidproliferationofdruginformation癌癥?？扑帋煹谋匾訲