OBJECTIVE: To probe into the safety and reasonability of TCM injection infusion prescription in outpatient and emergency department of hospitals in Tianjin.METHODS: Infusion prescriptions were randomly collected from outpatient and emergency department of secondary and three-tier hospitals in Tianjin.Reasonability of TCM injection intravenous infusion prescriptions were analyzed in respect of dosage and usage,compatibility and administration route.General information of patients and prescription were recorded.Primary data were classified,summarized and screened using EXCEL and the statistic data were calculated using SPSS11.0 software.RESULTS: 11 medical institutions were included and 2 309 TCM injection infusion prescriptions were collected within 4 days.Dosage and dosing interval of reasonable prescription accounted for 66.91% and 80.60% respectively.The safety compatibility proportion of prescriptions was only 58.64%.CONCLUSION: TCM injection infusion prescriptions in outpatient and emergency department of hospitals in Tianjin are reasonable while there is still some unreasonable compatibility of injection.

OBJECTIVE To investigate the variety of main pathogenic bacteria and their resistance in urinary system infection of type 2 diabetes mellitus(T2DM)in endocrinology department of our hospital and find out the best choice antibacterials of application.METHODS By retrospective analysis of clinical history,the results of urine bacterial culture,drug sensitivity reports of T2DM patients with urinary system infection were analyzed.The data were dealed with SPSS 11.0.RESULTS The drugs of experiential therapy were mainly quinolones.And drug resistant rates of Escherichia coli and Staphylococcus epidermidis to levofloxacin and ciprofloxacin were 18.2% and 63.6%,and 16.7% and 50.0% respectively.The treatment periods of 2 groups were(8.4?4.3)d and(10.4?5.4)d,respectively.CONCLUSIONS ?-Lactam/?-lactamase inhibitor and aminoglycosides are the first choice in experiential therapy.Thetreatment periods could be decreased according to bacterial culturingresults.

OBJECTIVE:To comprehend the causes for adverse drug reactions (ADR)associated with the traditional Chinese medicine injections in order to improve therapeutic safety.METHODS:Through tracking visits and retrospective study of patient cases,100 control cases and 93 ADR cases are analyzed in terms of medicine,patient,prescribing and nursing,both by single-factor and multi-factor approach.RESULTS:The main causes of ADR associated with traditional Chinese medicine injections are:overdosing,combined administration of drugs,longer-than-required time gap between dispensing and transfusion,failure to do pre-dosing liver or kidney function checkup,irrelevance of indication,lack of detailed instruction about way of administration and dosing,and lack of remarks on pharmacological action.CONCLUSION:It’s vitally important to improve prescribing and nursing behaviors for the sake of enhanced safety of clinical use of drugs.

OBJECTIVE:To investigate the characteristics and the prevention of traditional Chinese medicine-induced death. METHODS: The traditional Chinese medicine-induced death cases from 1994 to 2006 collected by retrieving full-text data base of CHKD were analyzed statistically. RESULTS: Of the total traditional Chinese medicine-induced death cases, drugs were chiefly administered by intravenous drip and oral administration, and allergic shock was the chief death causes. CONCLUSION: Clinicians and pharmacists should attach great importance on the ADRs induced by traditional Chinese medicines to ensure safe and effective drug use.

OBJECTIVE To analyze the pattern of antibiotic usage and antibiotic resistance tendency in our hospital.METHODS The use of antibiotics was evaluated by calculating DDDs;the bacteria were isolated and identified,and the susceptibility was tested by using microdilution method.Ten species of the most common bacteria,such as Staphylocccus aureus,and their antibiotic resistance tendency in two years were evaluated.RESULTS The average antibiotics days were 11.6 in two years.Ten species with 8967 strains were isolated in which 57.70% bacteria were Gram-negative.The rate of extended spectrum ?-lactamases(ESBLs) of Enterobacteriacae was 31.18%.42.3% Bacteria were Gram-positive,the isolation rate of MRSA was up to 76% and 56.8%,respectively.CONCLUSIONS The total cost of antibiotics remains at a high level.The ESBLs is still the major problem in gram negative germ.Vancomycin-resistant Enterococcus has been discovered.It is urgent to conduct epidemiological investigation and to take appropriate measures to control bacterial resistance and antibiotics usage.

OBJECTIVE:To investigate the incidence of adverse drug reactions(ADRs),the ratio of irrational drug use and the average daily drug costs after the initiation of clinical pharmacists' intervention on the combined use of antibiotic injections in the outpatient department.METHODS:By a controlled prospective study,500 patients in the intravenous center in outpatient department whose records were in line with inclusion criteria were included before intervention as controls,and after the initiation of clinical pharmacists' intervention on the combined use of antibiotic injection in the outpatient department,500 patients meeting the inclusion criteria were enrolled as trial group.A database was established and the results were analyzed statistically.RESULTS:The irrational drug use was noted in 52 cases in the control group versus 21 cases in the trial group and the ADRs or adverse drug events were noted in 18 cases for the control group versus 9 cases for the trial group.The daily mean drug cost reduced by 29.84 yuan after intervention.CONCLUSION:The intervention measures contributed to the reduction in incidences of irrational drug use and ADRs and drug costs.

OBJECTIVE:To improve the safety of antibiotic injections in outpatient department. METHODS:In a prospective randomized control study,outpatients treated with antibiotic injections in 2007 were chosen to be the subjects. The subjects were randomized into control group and intervention group. Education,administration intervention and inspection were adopted in clinical intervention considering the factor of drug combination. The rationality of drug combination and the incidence of ADR before and after intervention were observed. RESULTS:As compared with control group,the rationality of drug combination in intervention group was improved obviously(P

OBJECTIVE: To analyze the chief factors influencing the adverse drug reactions (ADR) in outpatient use of antibiotics so as to formulate corresponding policies for intervention. METHODS: The patients who had been treated i.v with antibiotics from Mar. 2006 to Mar. 2007 were enrolled: 105 in trial group showed ADR, another 105 in control group showed no ADR. The ADR influencing factors were compared between the two groups from aspects of patients, nursing, and medication to find out the significant differences. RESULTS: The chief factors influencing the adverse drug reactions (ADR) in outpatient use of antibiotics included the indications of drugs, dosage, dosing interval, drug combination, and availability of medication guidance. CONCLUSION: The outpatient intravenous use of antibiotics is far from rational, which needes further intervention.

OBJECTIVE; To improve the PIVAS quality management, reduce dispensing error and promote the safety of drug use.METHODS: The quality control circle (QCC) was used for quality management in PIVAS of our hospital. The reasons for dispensing errors were analyzed to determine the key improvement points using "the reduction of dispensing error of admixture drugs" as theme. Improvement plan was formulated, and effective countermeasures were determined by PDCA (Plan, Do, Check, Action) cycle management. The tangible results (the rate of dispensing errors) and intangible results were compared before (Feb. 2016) and after QCC (Aug. 2016). RESULTS: Some effective measures were formulated and implemented, including unified arrangement, introducing PIVAS MATE process management software, personnel post training, refining drug withdrawal management, visual management, etc. The tangible results included the rate of dispensing error decreased from 1. 81‰ to 0. 53‰; the rate of goal achievement reached 108. 47％; the rate of target progress was 70. 72％. The intangible results included optimizing drug dispensing process, standardizing drug withdrawal systent and personal training system. Those achievement improved confidence, responsibility, sense of cooperation and cohesiveness of QCC members. Additional result was obtained, i. e. utility model patent for avoiding light storage box. CONCLUSIONS: QCC can effectively improve the management quality of PIVAS workflow and the safety of intravenous medication.

OBJECTIVE：To interpret the new version of the Implementation Plan for Enrollment and Assessment of Clinical Pharmacist Teacher Training Project of Chinese Hospital Association （Trial）（hereinafter referred to as the “New Plan ”）officially announced by the Chinese Hospital Association in Sept. 2021，in order to provide guidance and reference for smoothly promoting the implementation of the New Plan and realizing the original intention of the reform. METHODS ：The New Plan was interpreted from four aspects ，including the background of the formulation of the New Plan ，the main features presented ，the innovations and the issues that need to be paid attention to in the next implementation. RESULTS & CONCLUSIONS ：The formulation and release of the New Plan marks the beginning of a new round of reform of the clinical pharmacist teacher training program of the Chinese Hospital Association. It is mainly based on the actual problems encountered in the operation of the current clinical pharmacist teacher training system ，the importance of clinical pharmacistteacher training itself ，and the opportunities and challenges that the development of the times has brought to our country ’s 163.com clinical pharmacy business. Research foundation ， problem orientation and professional demonstration present important characteristics. Compared with the old plan ，the New Plan adds a substantive selection mechanism for majors ，which intends to achieve the necessary “strictness”in the enrollment process ；it reconstructs the overall training goal of the benchmarking project and the three-in-one assessment system ，which intends to achieve a reasonable “lax”of assessment link ；it removes restrictions on off-site training ，advocates wide-ranging professional docking，and improves the flexibility of the training system and process management. The implementation of the New Plan is a complex work involving multiple parties and is affected by many factors. It requires multiple teams to perform their duties and promote together. The teacher training base and expert team must understand the spirit of reform and achieve the stable implementation of the New Plan ；at the same time ，the communication between the project working group and the teaching base and experts should be strengthened ，and finally realize the original intention of the reform of cultivating more high-quality clinical pharmacy teachers.