Analysis on the diffusion path and mechanism of the unified drug management system of countywide medical communities / 中华医院管理杂志

Objective:To analyze the evolution path and diffusion mechanism of the unified drug management system of countywide medical communities in China, and provide references for the deepening implementation of the system.Methods:The policy documents of the central and provincial governments were retrieved with the keywords of " medical community" " drug management" " county-township-village integration" and " central pharmacy". By means of the policy diffusion theory, the evolution path of the diffusion of the unified drug management system for the countywide medical communities was identified from such dimensions as time, space and hierarchy. On the other hand, the action mechanism of the diffusion of the system was summarized from such aspects as competition, administrative instruction, learning and imitation.Results:A total of 36 effective policy documents were collected. The time diffusion of the drug unified management system of countywide medical communities was characterized by an " S" curve. By the end of 2022, there were 30 provinces implementing the countywide medical community drug unified management system, and the policy diffusion has entered a saturation and stagnation stage; spatial diffusion showed " proximity effect" ; hierarchy diffusion embodied the " leader follower" mode. In the process of policy diffusion, competition mechanism, administrative instruction mechanism, learning mechanism, and imitation mechanism coexisted, but there were difference in the dominant mechanism at different stages of policy diffusion.Conclusions:The unified drug management system of the countywide medical communities has been widely disseminated. It is recommended to promote the introduction of supporting policies, optimize the system evaluation system, and comprehensively use various diffusion mechanisms to promote the optimization of the system, so as to promote the deepening and sustainable operation of the system.

Cost-effectiveness of drug-management of hypertension among patients in selected secondary facilities in Nigeria: Empirical evidence for rational prescription choices / Costo-efectividad del manejo farmacológico de la hipertensión en pacientes de entidades de segundo nivel seleccionados en Nigeria: evidencia empírica para elecciones racionales de formulación

Abstract Background: The financial burden of managing hypertension in developing countries, where most of healthcare is funded out-of-pocket, is huge and poor patients cannot sustainably afford it. This is a challenge for most people, especially in sub-Saharan Africa with poor health indices, and this informed the investigation of the cost-effectiveness of anti-hypertensive drugs. Methodology: This was essentially a before-and-after study without control, in which blood pressure was assessed after commencing treatment with anti-hypertensive drugs among hypertensive patients. A systematic sampling technique was employed to recruit 320 participants from new patients attending cardiology clinic and admitted into the wards in four secondary health facilities offering specialized medical services in Nigeria. Results: The median cost of drug treatment of hypertension per week was N977.50; this cost was much lower for monotherapy than combined therapy. Similarly, the median costs of treatment per decrease in systolic and diastolic blood pressures were higher with combined therapy than monotherapy. The median cost of treatment per decrease in systolic blood pressure was higher than diastolic pressure. Diuretics had the most cost per decrease in diastolic blood pressure, while ACEI had the highest costs per decrease in systolic blood pressure and the highest cost per week. The lowest cost per week was recorded for beta-blockers, which also had the lowest cost per decrease in diastolic blood pressure and similar to the average cost per unit decrease in systolic blood pressure for centrally acting drugs. Conclusion: There was a significant improvement in blood pressure three months following the start of anti-hypertensive drugs. Beta-blockers appeared most cost-effective while diuretics as well as ACE inhibitors were the least. Monotherapy costs less per week, but it could not be proved from this study that it was more cost-effective than combined therapy.

Resumen Antecedentes: la carga financiera del manejo de la hipertensión en países en vías de desarrollo, donde la mayoría de la atención en salud es financiada por cuenta propia, es enorme, y los pacientes de escasos recursos no lo pueden costear de manera sostenible. Este es el reto para la mayoría de las personas, especialmente en África subsahariana que tiene indicadores de salud pobres, y esto fundamentó la investigación de la costo-efectividad de las drogas antihipertensivas. Metodología: esencialmente un estudio antes-después, sin control, en el cual se evaluó la tensión arterial luego de iniciar tratamiento con antihipertensivos en pacientes hipertensos. Se empleó una técnica de muestreo sistemático para reclutar 320 participantes de entre los pacientes nuevos atendidos en consulta de cardiología y hospitalizados en cuatro entidades de salud de segundo nivel en Nigeria. Resultados: el costo medio semanal del tratamiento farmacológico de la hipertensión fue de N977.50; este costo fue mucho menor para la monoterapia que para la terapia combinada. Asimismo, el costo medio de tratamiento por reducción en las cifras de tensión arterial sistólica y diastólica fue mayor con la terapia combinada que con la monoterapia. El costo medio de tratamiento por reducción en la tensión arterial sistólica fue mayor que para la tensión diastólica. Los diuréticos tuvieron el mayor costo por reducción en tensión arterial diastólica, mientras que los IECA tuvieron el mayor costo por reducción en tensión arterial sistólica y el costo más alto por semana. El costo más bajo por semana se registró para los beta-bloqueadores, los cuales también tuvieron el menor costo por reducción en la tensión arterial diastólica y un costo similar al promedio por unidad de reducción en la tensión arterial sistólica para los medicamentos de acción central. Conclusión: hubo una mejoría significativa en la tensión arterial luego de tres meses del inicio de drogas antihipertensivas. Los beta-bloqueadores parecieron ser los más costo-efectivos, mientras que los diuréticos e inhibidores de ECA fueron los menos costo-efectivos. La monoterapia costó menos por semana pero no se pudo comprobar con este estudio que fuera más costo-efectivo que la terapia combinada.

Multi-dimensional Focus on the Management and Clinical Use of Biosimilar Products / 中国药房

OBJECTIVE：To provide reference for summarize the management and clinical use levels of biosimilar products . METHODS：Related policies and regulations about approval and application of biosimilar products were retrieved from domestic and foreign supervision departments and WHO. The biosimilar products were described from multi-dimensional aspects of whole life cycle of drugs ，generic name and prescription ，indication extrapolation ，clinical drug exchange ，pharmacovigilance，medical insurance payment system ，education and training. RESULTS & CONCLUSIONS ：Biosimilar products refer to therapeutic biological products which are similar to the reference drugs which have been approved for marketing in terms of quality ，safety and effectiveness. In R&D ，production，circulation，use and supervision links，the management of biosimilar products has its own characteristics in different countries/areas/organization. In the R&D stage ，biosimilar products do not need to independently verify their safety and effectiveness ，but only step by step use analytical methods to gradually clarify their high similarity with reference drugs in terms of structure and function. The name of biosimilar products in China is the same as that of the original drugs ，and the general name was used in prescription. For FDA to approve the indication extrapolation of biosimilar products ，it needs to be based on the data and information at the time of application ，the safety and effectiveness information of reference drugs ，and the consideration of relevant scientific elements of indications. It needs to be evaluated and used conditionally under supervision. The standard of FDA approval is strict，that is to say ，the approval standard of realizing interchangeability is higher than that of biological similarity which has no such concept in China. The enterprise community ，regulatory agencies ，academic institutions and hospital drug rooms need to communicate and exchange ，and further strengthen post market risk control and safety monitoring. China’s medical insurance department should establish an appropriate payment system and encourage the use of biosimilar products through the payment system. Meclical workers should learn the characteristics of biosimilar products so that they can make good use of biosimilar products in practice on the basis of understanding their technical evaluation.

Practice of Multidisciplinary Collaborative Prescription Review Mode in Key Monitored Drugs Management in Our Hospital / 中国药房

OBJECTIVE：To provide referenc e for the construction of prescription review model in medical institution and key monitored drugs management. METHODS ：A multidisciplinary collaborative prescription review mode was established in the First Affiliated Hospital of University of Science and Technology of China （called“our hospital ”for short ）. The prescription management group （composed of the president in charge ，the director of pharmacy department ，the director of medical department and the person in charge of pharmacy ，medicine，nursing and administrative management ）was set up under the Pharmaceutical Affairs Management and Drug Treatment Committee ；and then prescription review expert group （be responsible for providing professional technical consultation and final evaluation of prescriptions ）and prescription review working group （be responsible for the initial evaluation of prescriptions ）were set up. According to the Drug Administration Law ，the Law of Licensed Doctors and the Law of Anti-unfair Competition Act and so on ，the Measures for the Supervision and Administration of Drug Purchase ，Sale and Use in our hospital was formulated. The multi-disciplinary collaborative prescription review procedure was established to intervene key monitored drugs prescriptions. The utilization rate of key monitored varieties and prescription reasonability in our hospital were investigated before （Jun. 2019）and after the intervention （Sept. 2019）by the mode. RESULTS ：The multidisciplinary collaborative prescription review mode was established sucessfully. The proportion of key monitored drugs in total drug sales amount decreased from 1.322％ before intervention to 0.735％ after intervention （P＝0.010）. The irrational rate of prescriptions decreased from 46.76％ before intervention to 15.70％ after intervention （P＝0.023）. The main types of irrational prescriptions were inappropriate usage and dosage （18.52％），inappropriate indications（12.50％），inappropriateroute of administration （9.26％）before intervention changed into inappropriate usage and dosage （15.70％）after intervention ； other irrational prescription types had been significantly improved. CONCLUSIONS ： The multidisciplinary collaborative prescription review model shows significant effect on key monitored drugs and reduce irrational use of this variety in the clinic significantly.

Status of Residual Drug Management in 50 Medical Institutions in China and Its Control Mode Construction and Appli cation Practice in Our H ospital / 中国药房

OBJECTIVE：To understand the current management situation and problems of residual drugs in medical institutions in China ，evaluate the practice effect of corresponding control mode of our hospital and to explore the countermeasures to reduce the production of residual drugs and standardize its management. METHODS ：By random sampling ，30 third-level hospitals and 20 second-level hospitals in different regions were selected respectively during May 1st to 31st in 2019. For the pharmaceutical personnel，doctors，nurses and other non-pharmaceutical personnel ，a self-designed questionnaire on the status quo of residual drugs in medical institutions was issued. Excel 2010 software was used to count basic data of valid questionnaire ，and the causes ， management status ，disposal status and possible hazards of residual drugs in medical institutions were analyzed. A management mode of residual drugs was established and implemented （involving reducing the generation of sources ，implementing process management，and strictly implementing disposal ）. The effects of the model were evaluated ，then the countermeasures and suggestions were put forward . RESULTS & CONCLUSIONS：A total of 400 questionnaires were sent out ，and 311 valid questionnaires were collected with effective recovery rate of 77.75％. The causes of drug residual were complicated ，which included the“combination”of the same drugs ，the pre-order dispensing ，adverse drug reactions ，poor compliance of patients ，wrong order imput，sudden transfer ，discharge or death of patients ，wrong dispensing or nurse check error ，etc. The management status of residual drugs was chaotic ，the disposal methods lacked of standardization ，which may lead to harm such as deterioration ，illegal Δ 基金项目：重庆市技术预见与制度创新项目（No.cstc2018jsyj- recycling and pollution . The established whole-link residual zdcxX0093） drug management model in our hospital ，mainly included ＊主管药师 ，硕士。研究方向 ：药事管理 、抗肿瘤药理 。电话： measures of introducing Clinical Departments Residual Drug 023-68774769。E-mail：513293274@qq.com Safety Management Regulations to clarify the responsibilities # 通信作者：主任药师，博士生导师，博士。研究方向：药事管理、 of management group ， clinical department ， pharmacy 临床药学。电话：023-68755580。E-mail：zrcq73@163.com department； using rational medication control software to 中国药房 2020年第31卷第8期 China Pharmacy 2020Vol. 31 No. 8 ·897· reduce prescription error ；increasing the frequ ency of drug inventory ；introducing Drug Withdrawal and Refund Management to clear out drug withdrwal process ；independently researching and developing “Residual Drug Recovery Management System ”to standardize and simplify the recovery process ；bringing the residual drugs into special fund project management for medical assistance. According to the operation management practice from Jan. to Oct. 2018，a total of more than 1 million yuan worth of residual drugs were recovered. The residual drugs that did not meet the recovery conditions should be destroyed according to the specified process ，and the case number of non-standard notification of ward management would significantly reduced. The whole-link mode management established by our hospital can effectively reduce the production of residual drugs and standardize their management and disposal. It is suggested that the state or province should issue special regulations on the management of residual drugs in medical institutions ，and each medical institution should formulate specific management measures suitable for its own unit. Meanwhile ，the management of residual drugs in medical institutions should be further standardized systematically by actively exploring the ways to reduce residual drugs ，formulating the corresponding financial account processing standards ， supporting incentive mechanism and other measures.

Revisão dos dispositivos legais e normativos internacionais e nacionais sobre gestão de medicamentos e de seus resíduos / Review of national and international legal and regulatory mechanisms on the management of drugs and the residues thereof

Resumo Este trabalho apresenta uma revisão descritiva de leis e normas adotadas pelos países da Europa, das Américas e Austrália sobre gestão de medicamentos e de seus resíduos. Esta revisão integra pontos relevantes de documentos oficiais das agências reguladoras desses países, bem como de trabalhos científicos importantes. Todos os países pesquisados realizam gestão de medicamentos concomitantemente com a gestão de seus resíduos, atuando desde programas de conscientização sobre o uso racional e os riscos dos medicamentos até na coleta e disposição segura de seus resíduos. A Alemanha, os EUA e a Suécia exigem uma avaliação prévia do impacto ambiental provocado pelo medicamento como critério de seu registro. Em destaque, a Suécia que periodicamente atualiza uma lista de medicamentos essenciais baseada na avaliação do risco e do perigo ambiental de seus resíduos. No Brasil, as medidas legais propostas como prescrição racional e logística reversa ainda não foram efetivamente implementadas. A avaliação prévia de impacto ambiental resguarda os riscos à saúde humana e da biota selvagem causados pela exposição aos resíduos de medicamentos. Portanto, esses modelos internacionais poderiam servir de base para discussões e/ou alterações legais e normativas no Brasil.

Abstract This paper presents a descriptive review of laws and regulations on the management of drugs and the residues thereof adopted by countries in Europe, the Americas and Australia. This review integrates relevant points of official documents of regulatory agencies in these countries, as well as important scientific works. All countries surveyed carry out drug management concomitant with the management of the residues thereof, ranging from awareness programs on the rational use and the risks of drugs through to the collection and safe disposal of such residues. Germany, the USA and Sweden demand a prior assessment of the environmental impact caused by a given drug as a criterion for its registration. Sweden is noteworthy in that it periodically updates a list of essential drugs based on risk assessment and the environmental risks posed by the residues thereof. In Brazil, the legal measures proposed including rational prescription and reverse logistics have not yet been effectively implemented. Prior environmental impact assessment safeguards the risks to human health and the wild biota caused by exposure to drug residues. Therefore, these international models could serve as a basis for discussion and/or legal and regulatory changes in Brazil.

Establishment of Management System of Special Drugs Based on Internet of Things / 医药导报

Objective To establish a real-time monitoring system for hospital special drugs based on internet of things. Methods According to the regulations of special drug administration, combining with the internet of things technology, realtime management of drugs in terms of purchasing, receiving, using and reporting loss recovery were realized. Results After the special drug management system was used, intelligent management of drug use, inventory supervision, application management and prescription audit was realized. Conclusion Establishnment of special medical institutions and drug dynamic supervision information platform and system can realize the whole process of the traceability management, not only improving the work efficiency, also improving the drug safety and management level.

Practice of High-alert Medicine Managem ent in Our Hospital Based on JCI and HIMSS Standard / 中国药房

OBJECTIVE： To provide reference for the management of high-alert medicine. METHODS： Based on the requirements of JCI and HIMSS standards， the mode of high-alert medicine management were established， including formulation of high-alert medicine list， identification and storage， prescribing medical order， reviewing medical order， dispensing and application， post-administration monitoring and other key management links. Then the effectiveness analysis was carried out. RESULTS： After implementing high-alert medicine management measures， the qualification rate of high-alert medicine storage increased from 29.28％ to 95.50％ and the incidence of irrational medical order involving high-alert medicine decreased from 3.43％ to 1.99％， with statistical significance （P＜0.01）. The errors of dispensing was reduced from 35 to 0 monthly， high-alert medicine-related adverse events reduced from 18 to 3 monthly， and the safety of high-alert medicine was greatly improved. CONCLUSIONS： Through the establishment of high-alert medicine management model based on JCI and HIMSS standards in our hospital， the management of high-alert medicine is standardized， the risk of drug use is reduced.

Problems and countermeasures on the management and application of antiseptic drugs in Chinese hospitals / 中华医院管理杂志

Antiseptic drugs are the most popular anti-infectious drugs in daily use in hospitals, making significant contribution to public health. In view of the increasingly serious problems in the use and management of antiseptic drugs, the Chinese government has taken a series of measures to guide their rational use. However, due to the imperfect regulatory mechanism and weak sense of rational drug use, the problem of irrational use of antiseptic drugs is still existing. By studying the current situation and existing problems of antiseptic drugs in the country, this paper discussed the effective management means of such drugs, and provided feasible strategies and suggestions for standardizing their rational use.

Practice and Reflection of Intelligent Construction in Our Hospital Pharmacy / 现代医院

Objective To provide referential information for intelligent construction in hospital pharmacy. Methods Combined with the practical application, this paper introduces the practice and experience of the intelligent construction of pharmacy in our hospital. Results The construction of intelligent hospital pharmacy improves the drug management level, improves work efficiency and increases the accuracy of the drug dispensing, increases medication guide time, improves patient compliance and satisfaction and reduces the work intensity of pharmacists. Conclusion The intelligent construction of hospital pharmacy has promoted the development of pharmacy and laid a good foundation for the comprehensive and in-depth development of pharmaceutical care.

Practice and Experience of Automated Dispensing Cabinet in Wards for Drug Management Mode / 中国药房

OBJECTIVE:To change the drug management mode in wards,promote drug use for patients timely and rationally. METHODS:Automated dispensing cabinet(ADC)was used to manage the drugs in some wards in our hospital,and introduce its use practice from aspects of drug management mode,pharmacists'management to ADC,related measures when using ADC manag-ing ward drugs,effect evaluation after using ADC(using species of base drugs,average time of dispensing temporary medical or-ders,drug returning times in 5 wards before and after using ADC as indexes),etc. RESULTS:Drug management method was es-tablished in ADC by screening drugs into the cabinet and developing process of taking drugs out. And pharmacists had achieved drug management in wards by establishing drug lists,conducting replenishment and inventory management,developing emergency plan,enhancing supervision and inspection,etc. Compared with before using ADC,average species of base drugs in the 5 wards increased from 65.8 to 157.2;average time of dispensing temporary medical orders dropped from 24.5 min to 5.8 min;and average drug returning times in 3 months decreased from about 200 times to about 20 times(P<0.05 or P<0.01). CONCLUSIONS:Us-ing ADC in wards for drug management has not only improved use convenience of drugs in wards,working efficiency of nurses as well as pharmaceutical care quality of pharmacists,but also has changed drug management mode and promoted rational drug use of patients.

Analysis on Hospital Drug Circulation and Related Problems of Accounting / 中国卫生经济

Hospital drug management was an important part of hospital management,the new Hospital Financial System and Hospital Accounting System made reform on the accounting and management of drugs,which put forward higher requirement on more objective,accurate and timely information,so as to provide important evidence for the hospital managers making scientific and reasonable decision for the management and development of hospitals.Based on the current status of hospital drug management,it analyzed the medicine circulation process and the corresponding accounting treatment,and summarized the method so as to provide reference ofr the further regulating drug management,optimizing the accounting,improving the economical benefits and management level of hospitals.

Design and Development of Drug Management System of Peacekeeping Medical Team / 中国药房

OBJECTIVE:To improve the drug comprehensive management level of peacekeeping medical team,achieve dynam-ic management of drug information and network. METHODS:The design and development of drug management system of peace-keeping medical team were introduced in terms of overall system architecture,technical routes,system function design,etc.,and the application effect was evaluated. RESULTS:The system was designed by referencing military hospital No.1 drug management system,adopting C/S two-tier architecture,which included system settings,drug dictionary management,inventory management and other 8 modules and numbers of sub-modules. It achieved drug getting out and entering warehouse,supplying maintenance man-agement,prescription dispensing,drug withdrawal and inquiries,expendable drug monitoring,rotation transfer export data,the whole English electronic medical instruments generation,data query statistics,timely query of drugs and disease diagnosis knowl-edge base and other functions. The application of system standardized drug management and significantly improved working efficien-cy of physicians and pharmacists. CONCLUSIONS:The application of the system promotes the transform of drug management from extensive management model to elaborating management model,and the data is safe and easy to operate.

Comparison of Work Mode and Effect Analysis in ICU Area of Our Hospital before and after the Applica-tion of Automated Drug Dispensing System / 中国药房

OBJECTIVE:To promote standard management of drugs in ICU area. METHODS:The change of work mode in ICU area of our hospital was analyzed and compared after the application of automated drug dispensing system(ADDS)as well as the change of related indicators 3 months before and after the application of ADDS;the effect of ADDS was evaluated. RESULTS& CONCLUSIONS:After the application of ADDS,the management of base drugs changed from open management to intelligent, closed-off and authority management;drug storage and cost management became more scientific,and staff allocation became more optimal. Under the condition of zero difference in the number of medical orders,initial medication time shortened from 170 min to 131 min (P<0.05),time of daily drug preparation and drug repercussion shortened from (81.20 ± 3.56)min to (30.04 ± 7.55) min,and (9.18 ± 2.79)min to (6.47 ± 4.66) min (P<0.05). The application of ADDS can improve work efficiency,standardize drug management,promote medical safety,and provide reference for initiating a new mode of drug management in wards.

Function and Application of Surgery Base Drug Management System in Our Hospital / 中国药房

OBJECTIVE:To construct surgery base drug management system,and to realize efficient and accurate drug man-agement in surgery room. METHODS:The functions of surgery base drug management system exploited by our hospital were intro-duced,and the effect of the system was evaluated in department of anesthesiology. RESULTS&CONCLUSIONS:The system pos-sesses the functions of surgery drug automated affiliated charge,standardized narcotics prescription autogeneration,discarded nar-cotics prescription auto-prescribing,and drug information summary statisticing and checking,etc. After the application of the sys-tem,nonstandard rate of prescription decreased from 12.7% of handwritten prescription to 0.1% of electronic prescription;the time of drug requisition and checking decreased from(8.5±1.6)min to 0 min and(7.6±1.0)min to(2.9±0.9)min(P<0.05 or P<0.01). The system standardizes medication behavior of physicians and improve their work efficiency,avoid the loophole of drug charge management,realize the consistency between the accounts and the real numbers of narcotics,improve the rate of quality pre-scriptions and narcotics management, and realize integration,automation,intellectualization and whole-course supervision of drug management in pharmacy and clinical departments.

Practice Experience of Pharmacy Drug Management in Drug Clinical Trial Institution of Our Hospital / 中国药房

OBJECTIVE:To promote the management of clinical trial drugs and to guarantee the quality of clinical trials. METHODS:According to the management regulatory requirements,in Good Clinical Practice(GCP)and Drug Clinical Trial In-stitution Qualification Review Inspection Standard for clinical trial drug the problems including hardware facilities,personnel and re-cording documents such as receiving,storing,dispensing and recycling for surplus drugs were reviewed,meanwhile,countermea-sures and relative suggestions were put forward. RESULTS & CONCLUSIONS:The hardware facilities and personnel meet the re-quirements of GCP,but many recording documents such as receiving,storing,dispensing and surplus drug recycling are incom-plete and should be improved in our hospital. Therefore,the improvement of the process of experimental drug flow management and the complement of record of the documents are established. And suggestions about the establishment of electronic drug manage-ment system,pharmacists to take an active part in the whole process of drug clinical trials intervention,the establishment of full-time pharmacist to manage the clinical trial drugs in the clinical trial institution pharmacy are put forward.

Application of Intelligent Narcotic Drug Management Cabinet in the Narcotic Drug Management in the Outpatient Pharmacy of Our Hospital / 中国药房

OBJECTIVE:To promote the informationization and standardization of narcotic drug management so as to enhance the level of pharmacy management. METHODS:The function of intelligent narcotic drug management cabinet and its application in our hospital were introduced. The application effects were evaluated by comparing the indexes in 1 month(or 1 quarter)before and after the adoption of the cabinet. RESULTS:The intelligent narcotic drug management cabinet used in our hospital had such func-tions as login,getting drugs,adding drugs,expiration date management,inventory query,update,shifting of duty,record and da-ta processing. After the adoption,the inventory decreased by 35.2%,turnover rate increased by 53.4%;the time of applying for and registering narcotic drugs by the keeper of secondary warehouse respectively shortened by 84.1%(13.2 min vs. 2.1 min) and 88.9%(10.8 min vs. 1.2 min);and the incidence of external errors reduced from 3 times to once,an decrease of 66.7%. Mean-while,high integration of space improved the overall image of the pharmacy and the automatic pharmacy was constructed on a cer-tain scale and in a systematic manner. CONCLUSIONS:The application of intelligent narcotic drug management cabinet to the out-patient pharmacy can reduce the inventory cost,increase work efficiency and the safety of drug use,and make the narcotic drug management more standard,scientific and sophisticated.

Practice of Opening Operation Pharmacy Management Mode Based on Joint Commission International Ac-creditation / 中国药房

OBJECTIVE:To regulate the management of operation drug and promote medication security. METHODS:Based on the relevant principles in the standard of JCI,the practice about establishment of operation pharmacy in our hospital was intro-duced,and it were stated from two aspects which included working mode and effects. RESULTS:The working mode were format-ed by definiting the duties and working flow of pharmacist,anesthetist and liaison man. The establishment of operation pharmacy, which brought operation drugs into the unified management system of our hospital,saved manpower and improved work efficien-cy,refined the management of drugs in all aspects,improved the management of drug safety level,strengthened drug expiration date management,implemented the reporting of adverse drug reactions(event)and collecting of medication(potential)errors. The established mode conformed to the relative standard of JCI including preparation,grant,storage and collection of ADR of drug. CONCLUSIONS:The established drug management of operation pharmacy promotes standardized administration of surgery drug, which guarantees the drug use safety of patients.

Application of details management in ward drug administration / 现代临床护理

Objective To investigate the effect of detail management in ward drug administration.Methods Details management for ward drug management were applied,including the standardization of the drug storage,storage method,to carry out new knowledge learning,to strengthen the drug management,to set up the standardized nursing medication process identification and optimization measures.Results details management,the incidenues of drug mixed and delayed delivery were lower;the time of checking drug was significantly shorter(P<0?001).Conclusions The details management are the effective measures to ensure drug quality and safety.

Establishment and operation of an orphan drug management system / 中华医院管理杂志

The orphan drug management system can significantly improve the quality of care and that of life of patients suffering from rare diseases, and accelerate the progress of medicinal science. With experiences of practicing the orphan drug management system in developed countries and regions,including certification of orphan drugs, supports for developing orphan drugs, market protection and clinic application management. Based on such studies, the authors discussed the feasibility and methodology of establishing an orphan drug management system in China, along with the significance of such a system.