吴毓添  刘忠义

[摘要] 近几年医疗体系改革的不断发展与深入，使得医院药学工作的重心逐渐从“以药物为中心”转变成“以患者为中心”。自《医疗机构药事管理暂行规定》发布以后，医疗机构中逐步建立其临床药师制度，在临床药学工作中发挥了重要的作用，目前在一些三级医院中该项制度得到了良好的发展，然而在诸多的基层医院当中临床药学工作还处在初级阶段，效果不是十分理想，存在诸多的问题。本文从目前基层医院临床药学工作中存在的问题、工作重点、工作困境几个方面对基层医院临床药学工作现状进行了综述，共同探讨。

[关键词] 基层医院；临床药学；现状；重点；困境

[中图分类号] R951   [文献标识码] B   [文章编号] 2095-0616（2014）08-136-03

Current status of clinical pharmacy and emphasis and dilemma of implementing clinical pharmacy in primary hospitals

WU Yutian  LIU Zhongyi

Pingyuan People's Hospital in Guangdong Province,Pingyuan 514600,China

[Abstract] In recent years, with the continuous development and deepening of medical system reform, the emphasis of hospital pharmacy work has transferred from "drug-centered" to "patient-centered" gradually. Since the release of" Temporary Provisions on Pharmacy Administration of Medical Institutions",the relevant clinical pharmacist system has been established gradually in medical institutions, which has played an important role in clinical pharmacy work and obtained good development in some tertiary hospitals. However, in many primary hospitals,the clinical pharmacy work is still in the primary stage and the effects of this system are not quite ideal and many problems existe.This paper summarizes and investigates the current status of clinical pharmacy work in primary hospitals from the aspects of existing problems,work emphasis and work dilemma of clinical pharmacy work in primary hospitals.

[Key words] Primary hospital;Clinical pharmacy;Current status;Emphasis; Dilemma

目前而言，在基层医院的药学工作不容乐观，应引起重视[1]。本文从基层医院临床药学工作的现状、临床药学工作的重点与困境等几个方面进行了阐述。

1 存在的问题

1.1 制度不够完善

在二级与一级医院中多数没有设立专职的临床药师，以兼职和虚设为主，因医院存在较重的“重医轻药”的观念，因此对药师、临床药师的配制比例、设置范围等没有进行明确的规定[2]。并且基层医院的药剂科人员学历普遍较低，非药学专业人员占有一定的比例，药剂师大都承担着医院多方面的工作任务，多数需要药学专业的人员来完成，因此多数药学专业人员会被分配到药剂科而并没有设立临床药师[3]。

1.2 临床药师知识结构不合理，成……