Empirical antimicrobial therapy based on active surveillance cultures in ICU patients

Objetivo: Avaliar o valor preditivo da colonização prévia por Acinetobacter baumannii (CRAB) e Pseudomonas aeruginosa (CRPA) resistente a carbapenêmicos estabelecida em culturas de vigilância para infecção subsequente por esses patógenos em pacientes internados em UTI. Métodos: Foi realizado um estudo de coorte com pacientes internados na unidade de terapia intensiva por pelo menos 48 h. Foram medidos os valores preditivos negativos e positivos, sensibilidade e especificidade das culturas de vigilância em CRAB e CRPA. Resultados: Foram incluídos 693 pacientes infectados. Pacientes previamente colonizados por CRAB e CRPA tiveram maior probabilidade de serem infectados por esses patógenos: OR ajustado: 10,34 (6,58 - 16,45; p < 0,001) e 2,30 (3,88 - 10,26; p < 0,001), respectivamente. Encontramos altos valores preditivos negativos de culturas de vigilância para CRAB (87,18%) e CRPA (88,30%) e alta especificidade 91,96% e 90,13%, respectivamente. Conclusões: Pacientes não colonizados por CRAB e CRPA mostraram-se menos propensos à infecção por esses patógenos. Esses achados podem contribuir para a escolha da terapia antimicrobiana empírica e desencorajar a prescrição de antibióticos contra esses patógenos em pacientes sem colonização prévia.

Objective: To assess the predictive value of prior carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) colonization established in surveillance cultures for subsequent infection by these pathogens in ICU patients. Methods: A cohort study was performed with patients admitted to the intensive care unit for at least 48 h. Negative and positive predictive values, sensitivity, and specificity of surveillance cultures in CRAB and CRPA were measured. Results: 693 infected patients were included. Patients previously colonized by CRAB and CRPA were more likely to be infected by these pathogens: adjusted OR: 10.34 (6.58 - 16.45; p < 0.001) and 2.30 (3.88 - 10.26; p < 0.001), respectively. We found high negative predictive values of surveillance cultures for CRAB (87.18%) and CRPA (88.30%) and high specificity 91.96% and 90.13%, respectively. Conclusions: Patients not colonized by CRAB and CRPA were less prone to infection by these pathogens. These findings may contribute to the choice of empirical antimicrobial therapy and discourage the prescription of antibiotics against these pathogens in patients without previous colonization.

A cross-sectional evaluation of behavior and attitude of pharmacists toward dispensing non-OTC drugs without prescription in a city of Southern Rajasthan

Background: Over the counter (OTC), drugs are found to be safe and appropriate for use without supervision of a healthcare professional such as physician and they can be purchased by consumers without prescription. The study gains its importance because of the spreading of misuse of antibiotics and various drugs adverse drug reactions in the society. Aims and Objectives: The main aim of the study is to observe as to how many pharmacists/chemists/drug store sellers follow or violate the drug cosmetic act. Materials and Methods: It is an observational and cross-sectional study conducted among pharmacies of Udaipur city, urban areas of Southern Rajasthan. The study includes a sample size of 200 pharmacies selected through convenient random sampling. A detailed semi-structured questionnaire is administered to the pharmacists. The set of questions include types of drugs, reason for dispensing, knowledge, and attitude of pharmacist toward dispensing non-OTC drugs. All the private pharmacies willing to participate were included in the study. Data are entered in Microsoft Excel and statistically analyzed. Results: The results throw light on the behavior and pattern of dispensing habits of the drug store sellers of the city of Udaipur, Southern Rajasthan. It was observed that many pharmacists are in fact in the habit of dispensing non-OTC drugs in almost all the areas. Conclusions: Results give insights about the groups of drugs, logic, behavior, and knowledge level of pharmacists involved in dispensing practices in the city of Udaipur. There should be structured educational campaigns (or use of media, internet, newspaper, radio, television, advertisements, mobiles, etc.) for both pharmacists and public.

Tratamiento farmacológico para tromboembolismo pulmonar dirigido a pacientes con fibrilación auricular / Pharmacologic treatment for pulmonary thromboembolism in patients with atrial fibrillation / Tratamento farmacológico para tromboembolismo pulmonar em pacientes com fibrilação atrial

La fibrilación auricular es una de las arritmias cardiacas más frecuentes. Afecta a 1 de cada 200 personas de entre 40 y 50 años de edad, pero puede llegar a afectar a más de 1 de cada 10 personas de 80 años. Objetivo. Proponer una guía de tratamiento farmacológico para evitar el tromboembolismo pulmonar en pacientes con fibrilación auricular con respuesta ventricular. Materiales y métodos. Los métodos utilizados fueron de nivel teórico como histórico lógico, modelación, hipotético- deductivo, dialectico, holístico-holográfico y sistémico estructural- funcional. Como métodos empíricos. se aplicaron la revisión de documentos guías, historias clínicas, encuestas a médicos y farmacéuticas, también se realizó la observación científica, los resultados se reflejaron la revisión de las historias clínicas de los 38 pacientes con diagnóstico de fibrilación auricular crónica. Resultados. Se representa el tipo de tratamiento con un predominio de 24 pacientes que toman anticoagulantes (63,16%), los pacientes en su mayoría no estaban anti coagulados, pacientes anti coagulados (34,62%), además se elaboró la propuesta de una guía de tratamiento farmacológico para evitar el tromboembolismo pulmonar en pacientes con fibrilación auricular con respuesta ventricular rápida, de acuerdo a los estándares internacionales para para prevenir las complicaciones tromboembólicas de la fibrilación auricular. Conclusiones. Debido a su prevalencia creciente, al impacto en la supervivencia, la calidad de vida de los pacientes, los elevados costos sanitarios que conlleva su tratamiento y el incesante avance en nuevos tratamientos de la fibrilación auricular con respuesta ventricular rápida, hace que sea necesario actualizar de manera periódica las recomendaciones basadas en la evidencia.

Atrial fibrillation is one of the most common cardiac arrhythmias. It affects 1 in 200 people between 40 and 50 years of age, but may affect more than 1 in 10 people in their 80s. Objective. To propose a pharmacological treatment guideline to prevent pulmonary thromboembolism in patients with atrial fibrillation with ventricular response. Materials and methods. The methods used were of theoretical level as historical-logical, modeling, hypothetical- deductive, dialectical, holistic-holographic and systemic-structural-functional. As empirical methods, the review of guidelines documents, clinical histories, surveys to physicians and pharmacists were applied, as well as scientific observation, the results were reflected in the review of the clinical histories of the 38 patients with a diagnosis of chronic atrial fibrillation. Results. The type of treatment is represented with a predominance of 24 patients taking anticoagulants (63.16%), most of the patients were not anti coagulated, anti coagulated patients (34.62%), also the proposal of a pharmacological treatment guide to avoid pulmonary thromboembolism in patients with atrial fibrillation with rapid ventricular response was elaborated, according to international standards to prevent thromboembolic complications of atrial fibrillation. Conclusions. Due to its increasing prevalence, the impact on survival, the quality of life of patients, the high health care costs involved in its treatment, and the incessant advance in new treatments for atrial fibrillation with rapid ventricular response, it is necessary to periodically update the evidence-based recommendations.

A fibrilação atrial é uma das arritmias cardíacas mais comuns. Afeta 1 em cada 200 pessoas entre 40 e 50 anos de idade, mas pode afetar mais de 1 em cada 10 pessoas em seus 80 anos. Objetivo. Propor uma diretriz de tratamento farmacológico para prevenir o tromboembolismo pulmonar em pacientes com fibrilação atrial com resposta ventricular. Materiais e métodos. Os métodos utilizados foram de um nível teórico, como histórico-lógico, modelagem, hipotético-dedutivo, dialético, holístico-holográfico e sistêmico-estrutural-funcional. Como métodos empíricos, a revisão de documentos de orientação, históricos clínicos, pesquisas de médicos e farmacêuticos foram aplicados, assim como a observação científica, os resultados foram refletidos na revisão dos históricos clínicos dos 38 pacientes com um diagnóstico de fibrilação atrial crônica. Resultados. O tipo de tratamento é representado com uma predominância de 24 pacientes tomando anticoagulantes (63,16%), a maioria dos pacientes não era anticoagulante, anticoagulante (34,62%), e uma proposta de um guia de tratamento farmacológico para prevenir o tromboembolismo pulmonar em pacientes com fibrilação atrial com resposta ventricular rápida foi elaborada, de acordo com as normas internacionais para prevenir complicações tromboembólicas da fibrilação atrial. Conclusões. Devido a sua crescente prevalência, o impacto na sobrevivência, a qualidade de vida dos pacientes, os altos custos de saúde envolvidos em seu tratamento e o incessante avanço em novos tratamentos para fibrilação atrial com resposta ventricular rápida, é necessário atualizar periodicamente as recomendações baseadas em evidências.

An analysis of pharmaceutical care for critical patients of an adult Intensive Care Unit

Abstract This work analyzed the pharmacotherapeutic problems identified by the clinical pharmacist in an intensive care unit (ICU) and the acceptance of pharmaceutical interventions in solving these problems. This is a descriptive cross-sectional retrospective study, carried out in the adult ICU of a public hospital. All patients hospitalized during the study period had their pharmacotherapy monitored and those whose stay at the ICU lasted less than 24 hours were excluded. The pharmacotherapeutic problems were classified according to type, cause, acceptability/implementation, mode of intervention, outcome and related pharmacotherapeutic group. 302 patients were followed up and 350 pharmacotherapeutic problems were identified. Most of them were classified as unnecessary drug-treatment (n=186; 53.1%). The most frequent causes were excessive drug administration (n=181; 97.3%), and antimicrobials was the main group of drugs associated to that type of problem. 350 pharmaceutical interventions were performed, highlighting "prescriber informed only" (n=178; 50.9%), with an average acceptability of 90.7%, with those carried out on site being more effective (93.4%). The number of pharmacotherapeutic problems that were totally solved was 282 (80.6%). Clinical pharmacy activities in the ICU identified, prevented and corrected pharmacotherapeutic problems, contributing to the optimization of pharmacotherapy in aspects related to the need, efficacy and safety of treatments.

Exploring Work Satisfaction and Characteristics of Iraqi Pharmacist Workforce

Abstract The objectives of this study were to describe work characteristics of Iraqi pharmacists, to compare pharmacist job satisfaction between private and public sectors and to assess factors influencing job satisfaction level. This cross-sectional study of pharmacists, their work sites and work satisfactions used an electronic questionnaire that was posted on Facebook pharmacy professional group from June to September 2018. The participants included pharmacists from all 18 Iraqi provinces. We used multiple linear regression to identify predictors of general job satisfaction among 13 pharmacist characteristics. We received 658 usable surveys. Approximately half (47.24%) of respondents indicated dissatisfaction with their primary workplace. Job performance, patient contact, satisfaction with manager, income and expectation satisfactions were significantly related with work satisfaction. Pharmacists working in the private sector had significantly more control over their workplace and higher satisfaction with manager, income and general satisfactions compared to those working in public sector. Pharmacists work in diverse settings across the public healthcare system, community pharmacies, private drug bureaus and academia. About half of them are dissatisfied with their primary workplace. The private sector has more satisfaction rate compared to the public sector. Thus, officials need to improve job environments in the public sector.

Protocol for the implementation of pharmaceutical care in geriatrics: strategy for safety in health care / Protocolo para la implementación de la atención farmacéutica en geriatría: estrategia de seguridad en la atención sanitaria / Protocolo da implantação do cuidado farmacêutico na geriatria: estratégia para segurança na assistência à saúde

ABSTRACT Objective: To describe the experience of the implementation of pharmaceutical care in a geriatric hospital unit and to propose an instructional protocol for the practice. Methods: Experience report that became the practice manual of pharmaceutical care in geriatrics (MaP-CFarmaGeri) of a Brazilian hospital and was structured in three topics (1. Situational diagnosis; 2. Adequacy of the procedure and service provision; 3. Practice exercise). Results: The situational diagnosis comprised the collection of data on the structure of the ward and the epidemiological profile. The pharmaceutical services provided included pharmacotherapeutic follow-up, medication reconciliation and pharmacotherapy review. The certification of the content of this procedure was attested by specialists from a multiprofessional team and the technique served more than 60 patients in practice, with good acceptance by the participants. Final considerations: The MaP-CFarmaGeri proved to be a satisfactory strategy in the implementation of pharmaceutical care in geriatrics and can support this insertion in similar locations.

RESUMEN Objetivo: Describir la experiencia de implementar la atención farmacéutica en una unidad hospitalaria geriátrica y proponer un protocolo instructivo para la práctica. Métodos: Informe de experiencia que se convirtió en el manual de la práctica de la atención farmacéutica en geriatría (MaP-CFarmaGeri) de un hospital brasileño y se estructuró en tres temas (1. Diagnóstico situacional; 2. Adecuación del procedimiento y prestación del servicio; 3. Ejercicio de práctica). Resultados: El diagnóstico situacional comprendió el relevamiento de datos sobre la estructura de la sala y el perfil epidemiológico. Los servicios farmacéuticos ofrecidos incluyeron seguimiento farmacoterapéutico, conciliación de medicamentos y revisión de farmacoterapia. La certificación del contenido de este procedimiento fue certificada por especialistas de un equipo multidisciplinario y la técnica trató a más de 60 pacientes en la práctica, con buena aceptación por parte de los participantes. Consideraciones finales: El MaP-CFarmaGeri demostró ser una estrategia satisfactoria en la implementación de la atención farmacéutica en geriatría y puede apoyar esta inserción en lugares similares.

RESUMO Objetivo: Descrever a experiência da implantação do cuidado farmacêutico em uma unidade hospitalar de geriatria e propor um protocolo instrutivo da prática. Métodos: Relato de experiência que se converteu no manual da prática do cuidado farmacêutico na geriatria (MaP-CFarmaGeri) de um hospital brasileiro e foi estruturado em três tópicos (1. Diagnóstico situacional; 2. Adequação do procedimento e oferta do serviço; 3. Exercício da prática). Resultados: O diagnóstico situacional compreendeu o levantamento dos dados sobre a estrutura da enfermaria e o perfil epidemiológico. Os serviços farmacêuticos ofertados incluíram o acompanhamento farmacoterapêutico, com a conciliação de medicamentos e a revisão da farmacoterapia. A certificação do conteúdo desse procedimento foi atestada por especialistas de uma equipe multiprofissional e a técnica atendeu mais de 60 pacientes na prática, com boa aceitação dos participantes. Considerações finais: O MaP-CFarmaGeri mostrou ser uma estratégia satisfatória na implantação do cuidado farmacêutico na geriatria e pode amparar essa inserção em locais semelhantes.

Sem-edx Analysis Of Abhraka Bhasma Prepared According To Rasa Ratna Sammuchchaya

Bhasmas are the most frequently used medicines in the field of Ayurveda as it tends to act fast when compared to other modes of medication. It works on the principle of nanoparticle assimilation, which provides higher bioavailability due its higher surface area and lesser particle size. This invention was made back in ancient days, which proves that during those ages there were faster methods of medical aids for a disease proving to be fatal. Abhraka is one of the main drugs used in Ayurveda mainly in the form of a Bhasma. It is abundantly used in single / compound forms for diseases like Cold, Cough, Diabetes, Anemia, asthma, etc. For a Bhasma to act significantly without side-effects it has to be properly rendered to purifactory procedures and Incineration at optimum temperature. This article basically deals with Samanya Shodana, Dhanyabhraka nirmana and Marana of Abhraka followed by its analysis by SEM-EDX which proved that There was reduction in some of the elements present in the drug after giving successive putas, till the formation of a Bhasma.The atomic percentage of Oxygen increased when bhasma was formed, hence suggesting it to be in oxide form. There was absence of heavy metals after giving puta according to the classical reference. Microscopic images of the Churna and Bhasma could be analysed and the Particle size of bhasma could be analysed which was 580.2 nm.

Influence of PDCA cycle combined with LBL/TBL teaching models on the clinical training of pharmacy interns / 中华医学教育探索杂志

s] Objective To understand the influence of PDCA cyclecombined with LBL/TBL teaching models on the problem-solving ability and clinical training of pharmacy interns so as to improve the teaching quality of hospital pharmacy practice. Methods A total of 126 hospital pharmacy interns were randomly divided into the control group (63 interns) and the experimental group (63 interns). The control group was taught with LBL/TBL teaching models, while the experimental group was taught with PDCA cycle combined with LBL/TBL teaching models . Questionnaires were used to investigate the problem-solving ability , the teaching effect of clinical training , and the satisfaction in the two groups after the clinical training. Results The scores of positive problem orientation and rational problem solving were higher in the experimental group than in the control group (P<0.05). The scores of negative problem orientation, avoidance style, impulsivity/carelessness style were lower in the experimental group than in the control group(P<0.05). The scores of theoretical knowledge ( 86 . 5 ± 8 . 5 ) and clinical skills ( 87 . 0 ± 7 . 2 ) were higher in the experimental group than in the control group (P<0.05). Besides, the investigation on the satisfaction to clinical training showed that the practical ability, teamwork consciousness and self-learning ability were better in the experimental group than in the control group (P<0.05). The total satisfaction of the experimental group was 92.2％, higher than that of the control group (83.5％) (P<0.05). Conclusion PDCA cycle combined with LBL/TBL teaching models can improve the problem-solving ability and the teaching effect of clinical training in pharmacy interns, which deserves wider application.

Exploring The Interface Between Complementary Medicine And Community Pharmacy In Malaysia – A Survey Of Pharmacists

@#The use of complementary medicine (CM) is on the rise worldwide. In Malaysia, CM is available as over-the-counter products in community pharmacies and consumers expect pharmacists to be knowledgeable about CM. However, little is known about Malaysian community pharmacists’ attitude and knowledge of CM. This cross-sectional study aimed to investigate the extent of integration of CM into practice, taking into account community pharmacists’ attitudes towards CM, their role in recommending CM, their knowledge of the evidence-base for commonly used CM, further education and training needs, and knowledge of information sources which can be used by pharmacists for CM information. Ethics approval was obtained and a pilot study was conducted to validate the questionnaire. After amendments were made, community pharmacists were invited to complete a 41-item paper-based or web-based questionnaire. Invitations to complete the survey were sent by either social media, email or face-to-face invitation. A response rate of 27% (453/1662) was achieved providing data from 453 community pharmacists. Most respondents were female (63%), aged 24-72 years. Only 42% of pharmacists always asked their customers presenting with a prescription about concomitant CM use. Forty-two percent (42%) of pharmacists personally recommended CM and slightly more than half (58%) had notified manufacturers of CM products of any suspected adverse drug reactions. On average, pharmacists achieved a score of 54% for knowledge on CM-drug interactions and 71% for knowledge of clinically proven benefits. Most pharmacists (75%) obtained their CM product training through self-directed learning. In addition, most pharmacists (66%) supported CM education at the undergraduate level and almost all (94%) recognised the need for additional CM education for pharmacists. Malaysian registered pharmacists do not routinely ask customers about CM use, or recommend CM products, but have a positive attitude towards their use and were interested in learning more about CM.

Long Term Assessment of Outcome of Essential Competencies in CPPE at Tertiary and Secondary Hospitals Located in Seoul and Gyeonggi-do: College of Pharmacy Students' Evaluation from 2014 to 2018

OBJECTIVE: As the demands of healthcare environment change, it is necessary to advance human health care by improving students' essential competencies including knowledge, skills, abilities, inter-professional collaboration and patient centered care. This study identified long term accomplishment and improvement of the essential competencies in clinical pharmacy practice education (CPPE) at Korean hospitals over time. METHODS: This study was conducted for pharmacy students who completed CPPE evaluation related to tertiary hospitals and secondary hospitals located in Seoul and Gyeonggi-do regional area from 2014 to 2018. RESULTS: Over the past 5 years, overall results of student evaluation on the essential competencies in CPPE at both tertiary and secondary hospitals showed a decreasing trend or did not change. Essential competency in CPPE at tertiary hospitals had been identified as superior on ‘Learn clinical knowledge in the treatment of diseases’ to secondary hospitals [average number of students (%): 210 (72.9%) vs 68 (68.0%)]. On the other hand, essential competencies in CPPE at secondary hospitals had been identified as better at ‘inter-professionals collaborative teamwork and direct patient care’ than tertiary hospitals [average number of students (%): 64 (64.0%) and 56 (56.0%) vs 121 (42.0%) and 90 (31.3%)]. A total of 176 (61.1%) students in tertiary hospitals and 66 (66.0%) in secondary hospitals evaluated that ‘patient-centered care’ education was good. CONCLUSION: In tertiary hospitals, all six essential competency outcomes have not been improved, whereas four essential competency outcomes showed an increasing trend in secondary hospitals. It will be necessary to develop outcome-based CPPE education program to better reflect the essential competencies.

Evaluation of Pharmacy Students' Perception on Clinical Pharmacy Practice Experience in the Tertiary and Secondary Hospital settings

BACKGROUND: Clinical Pharmacy Practice Experience (CPPE) is an important curriculum that offers students patient-centered disease prevention and treatment with evidence-based optimal pharmacotherapy for better clinical outcomes. However, few studies have evaluated the perception of pharmacy students regarding CPPE in tertiary and secondary hospitals. This study aimed to evaluate the perception of pharmacy students regarding the learning program of CPPE. METHODS: The survey questionnaire consisted of 15 self-administered questions regarding pharmacy practices, barriers, and improvement of practical training. Fourteen institutional pharmacies located in seven regions responded to a survey questionnaire from March 1 to June 30, 2017. The participants were pharmacy students doing clerkship in a hospital setting. RESULTS: The response rate was 73.6%. Thirty-five participants (22.4%) had used a hospital library, but 121 (77.6%) had never used the library for drug information resources. Eighty-one (50.0%) responded that clinical knowledge and drug information was the most beneficial practice. Thirty-seven (31.1%) respondents in the tertiary hospitals and 19 (46.3%) in the secondary hospitals answered that they were filling prescriptions during the daily break. On the other hand, 72 respondents (60.5%) in the tertiary hospitals and 17 (41.5%) in the secondary hospitals did literature research to prepare for presentation. CONCLUSION: More students in secondary hospitals continue to fill prescriptions during the daily break, as compared to those in tertiary hospitals. Therefore, the authors suggest self-directed learning to improve clinical performance and each institution considers offering onsite or online library service to improve evidence-based CPPE for pharmacy school students.

Practice of clinical pharmacy specialty development at obstetrics and gynecology hospitals / 中华医院管理杂志

The hospital, specialized in obstetrics and gynecology, has developed a specialty development system and clinical practice model based on its clinical pharmacy practice. The model features enhancing the service capability of clinical pharmacologists, development of a pharmacologist training pipeline, enhanced popularization of relevant knowledge, and tapping potential for clinical pharmacy research. These experiences provide useful references for pharmacy specialty development at specialized hospitals.

Practice of Medication Reconciliation among Chronic Renal Insufficiency Patients by Clinical Pharmacists / 中国药房

OBJCETIVE:To investigate the role of clinical pharmacists in medication reconciliation. METHODS:Totally 200 inpatients admitted or transferred to nephrology department of our hospital during Aug.-Oct. 2015 were selected. Within 48 h after admission,1-year medication history were collected by reviewing electronic medical records,consultation,querying self-prepared drugs and medical history;and then medication reconciliation was conducted by clinical pharmacists. RESULTS:Among drug lists collected by clinical pharmacists,there were 987 kinds of drugs,but only 9.63%(95 kinds) drugs were recorded in the medical records. There were 5 cases of ADR in total,and only 40.00% of them (2 cases) were recorded in the medical records. Among 200 patients,medication reconciliation was needed in 45 cases with reconciliation rate of 22.50%. Among 492 medical orders of 200 patients,medication errors were found in 103 medical orders;the number of medication errors per case was (2.3 ± 1.8), mainly including wrong dose,repeated medication,wrong solvent,drug interactions;the potential risk degree was mainly degree 1 (53 orders,51.46%). Among 103 medication reconciliation orders,main plans were drug withdrawal (78 cases,75.73%), followed by drug change(17 cases,16.50%)and drug supplement(8 cases,7.77%). A total of 90 reconciled medical orders were adopted by physicians,with success rate of 87.38%. CONCLUSIONS:Compared with physicians,clinical pharmacists can obtain more detailed and accurate drug list. It can reduce medication error and guarantee the safety of drug use to maximum extent that clinical pharmacists conduct medication reconciliation.

The Students' Evaluation of Practice Sites and Preceptors in Pharmacy Experiential Education

OBJECTIVE: This study was conducted to assess the current status of experiential education, by analyzing pharmacy students' satisfaction and evaluation for practice sites and preceptors for 3 years from 2014 through 2016. METHODS: Students evaluated the practice sites and preceptors using a 5-point and a 4-point Likert scale, respectively. Analysis was performed based on the types of curriculums and practice sites. In addition, sub-analysis was conducted based on the types of health-system pharmacy and the community pharmacy. RESULTS: Total 203 students responded to the survey questionnaires. The 3-year average score of students' satisfaction with practice sites was 4.25. In the sub-analysis conducted based on the types of health-system pharmacy, the score was higher in the tertiary hospital pharmacies than that of the general hospital pharmacies (4.49 vs. 4.06, P<0.001). For community pharmacy, the difference in the score of the 3-year analysis was not significant, depending on the types (4.51 vs. 4.33, P=0.054). The average score of students' evaluation on the preceptors was 3.37 in the 3-year analysis. The score was significantly higher for the preceptors of tertiary hospital pharmacies than those of general hospital pharmacies (3.61 vs. 3.25, P<0.001). For community pharmacy, no significant differences were found, depending on the types of pharmacy (3.53 vs. 3.43, P=0.309). CONCLUSION: The students' satisfaction with practice sites and preceptors in pharmacy experiential education was high. However, it varied greatly depending on the types of educational institutions. Mutual effort between university and educational institutions is required, to narrow the gap in the degree of students' satisfaction.

Middle East Respiratory Syndrome Outbreak and Responsiveness of the Pharmacy Programs on the Pharmacy Practice Education

BACKGROUND: Pharmacy curriculum change was made from a 4-year program to a 2+4 year program in year 2009 in Korea. The change has resulted in more educational exposures on patient-centered practice environments for about 1,400 hours in the last year of the professional pharmacy program. When the Middle East Respiratory Syndrome (MERS) outbreak hit Seoul and suburban areas and propagated to other provinces in Korea, emergency response to avoid student infection in the pharmacy practice sites became an urgent issue. While other health professional programs such as medicine and nursing had activated emergency preparedness manuals, timely and clear guidelines were not disseminated to all pharmacy programs and protective measures largely relied on individual pharmacy program. METHODS: A survey was developed by the Committee on Pharmacy Practice Experience Programs in the Korean College of Clinical Pharmacy to document the status of pharmacy programs during the Korea MERS outbreak in 2015. The 10-question survey was distributed to the pharmacy practice experience coordinators to 34 out of 35 pharmacy schools in Korea by emails. RESULTS: Our findings showed that 82.4% of the program coordinators (28/34) responded to the survey, 96.4% of the programs did not have emergency preparedness manuals, administrative meetings were held in 89.3% of the pharmacy programs, the rotation schedules were modified or withheld in 53.6% of schools, and the changes were mostly observed from the programs classified as MERS outbreak regions. CONCLUSION: Further needs in establishing the emergency preparedness manual should be explored for pharmacy education stakeholders.

Providing Effective Feedback within Pharmacy Practice Education

Experiential education is a core curriculum of pharmacy education. In experiential education, formative feedback is an integral component of learning and teaching process. Feedback is defined as information provided by a preceptor regarding student's performance based on direct observation. With effective feedback, students can have opportunities to reinforce or correct behaviors and to acquire knowledge or skills. Students highly value and appreciate feedback. They rank provision of effective feedback as one of the most important qualities of preceptors. Preceptors, however, lack an understanding of feedback or practical skills necessary for providing effective feedback. As a result in reality, the feedback provided to students can be differentially effective in improving students' learning. This article describes a theoretical understanding of feedback including definition and value, as well as types of feedback. In addition, practical aspects in providing feedback, such as contents, timing, techniques, and models, are addressed. By understanding the value of feedback and mastering various feedback skills, preceptors will promote students' learning and enhance educational outcomes of experiential education.

Investigation on Cognition of the Clinical Pharmacists on the Clinical Pharmacy Practice and Their Profes-sion in the Medical and Health Institutions in Shanghai / 中国药房

OBJECTIVE:To investigate the cognition of clinical pharmacists on the clinical pharmacy practice and their profes-sion,and provide reference for further developing clinical pharmacy practice. METHODS:A questionnaire was designed,and ran-dom sample was conducted for the clinical pharmacists from 30 secondary and tertiary hospitals in Shanghai,and the investigation results were analyzed statistically. RESULTS:Totally 130 questionnaires were sent out,and 102 were effectively received with valid response rate of 78.46%. 94.11% of the investigated subjects were willing to be a clinical pharmacist,but 17.65% of them consid-ered that they were incompetent for their work;29.41% of them thought the current situation of clinical pharmacy practice was not ideal;all the respondents considered that the clinical pharmacist system should be implemented in medical and health institu-tions;the cognition and evaluation of investigated subjects in tertiary hospitals on clinical pharmacy practice and their profession was generally higher than those in secondary hospitals(P<0.05). CONCLUSIONS:The clinical pharmacists in medical and health institutions in Shanghai showed high cognition on their profession,and the clinical pharmacy practice has already made some achievements,but many work still need to be improved. Therefore,clinical pharmacists should continuously study their profession-al knowledge and improve their professional skills and quality;hospitals and universities should strengthen the subject construction and personnel training of clinical pharmacy and deeply carry out the clinical pharmacist system;health administration departments should strengthen the related laws and regulations of clinical pharmacy;colleges and universities should strengthen the discipline construction and personnel training.

Improving the Practice Teaching Quality of Pharmacy Undergraduates under the Collaboration of Medicine and Education / 中国药房

OBJECTIVE:To investigate new thought and method for improving the practice teaching effect of pharmacy under-graduates under the collaboration of medicine and education. METHODS:The training objectives of pharmacist team,the current sit-uations and problems of teaching that existing in the institute of pharmacy and the requirement of talents in the work were summa-rized and investigated,and then reform targets and measures were put forward. RESULTS:Training for pharmacists tream gradual-ly movedcloser to clinical pharmacists in China.The teaching work in the pharmacy department of our hospital was relatively com-plete,including relevant teaching system,practice systems and processes,training program for clinical pharmacists and develop-ment of workflow;however,there still remained some problems,including lacking of professional quality training,suitable cours-es,effective interactive medical and education scientific assessment mode and no attention for the training of clinical thinking and school-university research thinking. The above-mentioned problems needed to be solved by reforming internship tutorial system and improving the contents,establishing the school-hospital united system,emphasizing the connection between schools and teaching bases,establishing integrated teaching evaluation system and assessment criteria,strengthening clinical experience and training for clinical thinking by the teaching mode of physicians and pharmacists. CONCLUSIONS:Strengthening the collaboration of medicine and education and improving the training standards and evaluation system are helpful for improving the practice teaching quality of pharmacy undergraduates.

Practice of medication reconciliation services by clinical pharmacists of nephrolo-gy department / 药学实践杂志

Objective To discuss the important role of clinical pharmacists in medication reconciliation through the prac‐tice of clinical pharmacists of nephrology department .Methods The medication reconciliation serviced for the patients newly admitted to nephrology department was carried out through the way of interrogation .The difference and the causes between the results of pharmacist′s interrogation and the doctors′were analyzed .Results 20 patients were enrolled .The quantity was not consistent with what hospital doctor′s advice rate (60% ) ,drugs produced in different areas (55% ) ,different producing areas pharmacist had higher accuracy .Conclusion It had certain effect on medication management and could reduce the ADR .Clinical pharmacists and doctors should pay more attention on the medication reconciliation ,strengthen the ability of interrogation to im‐prove patient compliance and establish a complete medication reconciliation system .

NHS Hospital Pharmacist Training Programme in UK

The aim of the research was to explore post-registration training opportunities for NHS hospital pharmacists which contributes to promote structural reform of the professional development and lifelong learning for Korean hospital pharmacists. In UK, all pharmacists are required to complete at least 9 Continuing Professional Development (CPD) entries per each year to maintain their professional registration. Types of accredited postgraduate qualification (part-time) in Pharmacy Practice available for hospital pharmacists are Postgraduate Certificate (PgCert, year 1), Postgraduate Diploma (PgDip, year 2), Master of Science (MSc year 3), and Professional Doctorate in Pharmacy programme (DPharm, 4-5 years or more). Clinical pharmacy diploma is more likely to become a minimum qualification in order to progress whilst working for the NHS. Pharmacy independent prescribers are allowed to prescribe all medications except cocaine, dipipanone, and diamorphine for the purpose of treating addiction within their competencies. NHS pharmacists are also classified by band point system depending on their practical/clinical knowledge and skills which starting from band 5 (Pre-registration pharmacist) up to band 9. Various learning and development options are also offered including teaching sessions, conferences and local forums.