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|Thursday, 17-May-2012 01:54
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Implementation of prescription management method, what to bring
You have to cannot read the doctor and vexed ?You have because see the doctor and lost ?Since May 1st of this year, the new prescription management method has been implemented ,your visiting experience changed ?You must know the doctor prescription? Doctor and pharmacy medical personnel work and what changes ?Sohu Health reading for your interview record compere: each Sohu netizen ,everybody is good !Thank you very much for this period attention Sohu Health studio .
Through the Sohu Health Survey ,we find that ,some netizens have because cannot read the doctor and trouble, or because of cannot read the doctor ,maybe next time in the process of hospital would not know what to look for a doctor.
Starting from May 1st this year ,the new prescription management method has been the Minister of Health Gao Qiang minister to form the formal implementation of the clinic experience ,is it right? Change ,medical staff have to adjust? Today is special invite Sohu Health Ministry of health to Mr.
Li Dachuan ,Tsinghua University First Affiliated Hospital of Wei Jianying deputy director and deputy director of the physician Xu Peng came to live with the chat on Side of things .Topic today is prescription management method ,the Ministry of Health asked Mr.
Li Dachuan to give us introduce our country prescription management method of history. Li Dachuan :it should be said that from the doctor that day had prescription ,prescription management of our country can be traced back to 1982 ,is initially the doctors management system with single row of a mm prescription system: a total of 11, at the time of the prescription system is more on prescription form requirements ,and later because of prescription system has not been able to satisfy the needs of our clinical work ,so the Ministry of health in 2002 Organization expertsdrafted the prescription management method ( try out) ,and in 2004 August promulgation and implementation.
The trial version of the prescription management way in the prescribed format more raised requirements .In recent years ,we found that the approach has been unable to effectively solve the clinical problem ,especially the problem of rational drug use ,so from the beginning of last year and experts widely consulted the medical department ,pharmacy ,doctor department ,and many of the views of patients, develop a new prescription management method ,now we are implementing ,promulgated in April 12th 2007.
At the new Management approach features the first change ,the promotion of legal status .The original prescription management method is the Ministry of health policy documents ,and more as system requirements.
The new prescription administrative policy is the Ministry of health department regulations ,is the Minister of health to release form ,position improves .Means if not in accordance with the regulations shall be held liable.
Second changes ,for sexual enhancement .In addition to our prescription writing and standard problem ,put more and rational drug use is required to be implemented in prescription management method .
Third changes ,increased pharmacy departments responsibility medical work is needed .Physicians ,pharmacists ,nursing work ,so the prescription management way on the rational drug use audit role.
This is the new prescription management method the main changes ,of course content also increased a lot of ,say, the first clear up the doctor must be standardized prescription, second to buy drug category limit, third the practice of prescription evaluation system .
Through to the medical institutions and medical drug evaluation, timely intervention on medication ,and other Specific technical aspects of change ,more detailed. The main purpose is through the strengthening of management of prescription, including patients with drug use and safety ,ultimately improve medical quality and safety ,this is the prescription management method has some background and change.
Li Dachuan Ministry of health new prescription management method to the medical profession director in the eyes of the new prescription management method advantage :in accordance with the host just Lee said ,should say the Chinese prescription management regulations began in 2002 2004wererevised ,implemented a trial version ,then the director Xu and Wei officer should have gone through this process ,the process can work from you to experience a new prescription management method with the original trial version which operate on different ?Xu Peng deputy chief physician of First Hospital of Tsinghua University outpatient medical director of general office deputy director of Xu Peng :I feel like I just said Mr.
Li ,a new prescription management method in accordance with reasonable prescription requirements, no standard common name or as a unified standard the name. Another like prescription evaluation system ,it is also gradually in the process of application ,I think this may be a better Point .
We also compared on a provisional regulations ,Adidas Jeremy Scott,the physician prescription drugs which have further specification .The host: we see new approaches ,including the doctor diagnosis and other details were clear director Xu ,please share with us you find different.
Xu Peng :from the perspective of our get this prescription management method since carrying out ,we also downloaded from the Internet a number of standardized prescription ,also is very clear ,may in fact later hospitals are performing the same ,such as the pediatric anesthesia ,spirit ,like this is an emergency ,including ,as each different ,in the design of more a bit more reasonable ,such as some pharmacists tips ,including one follow the wills medication and so on ,in the standard is more reasonable ,is a united ,one is normative .
Again, like some medicine is special ,because it involves some special problems ,such as certain disease what medicine is more reasonable ,for example is a complication to drug use ,I think the doctor prescribe time should be written clearly ,if he does not write clearly the future as in medical insurance and expenses related to these issues will be There are some problems .
The new director Wei Jianying eyes prescription management method on pharmacist significance Moderator: we also see the new prescription administrative policy, should say with prescription related to various types of populations are divided ,the doctor should be how prescription, as well as how pharmacists monitoring prescribing is correct and so on .
Wei Jianying deputy director of Tsinghua University the First Affiliated Hospital Pharmacy director Wei Jianying :I said about pharmacy aspect influence ,because the prescription management way just as you said for writing requirements for doctors ,pharmacists ,Nike Air Force One,the management of the management .
The earliest pilot management approach to present the new prescription management method ,is a stage ,different the prescription management way of pharmacy will undoubtedly play oriented management, as a new prescription management method of the authority, is mainly to minister to make the form of fat ,so the whole nation all seriously study the prescription management way .
As our pharmacy work, no matter from the staff ,or management ,are more standardized ,detailed ,systematic ,give us the job points to clear direction .Because in the past some contents not A detailed review of ,and now ,what should do ?Should review what HH these are very careful ,do have ,fully embodies the law thought.
With the transformation of the mode of hospital pharmacy ,the pharmacy work demands more and more detailed, and is more and more high ,so as to achieve a gradual convergence with the world purpose.
Of course in some respects ,specific applications in the process there are some problems ,such as pharmacists .Patients with respect to work ,there are some practical difficulties ,but the direction of I think is recognized by everyone ,and also on pharmacist spur ,we need to constantly improve the technical content .
Moderator: because from the people themselves feelings ,always thought of pharmacy pharmacists just medicine simple work ,actually pharmacists, especially for patients with drug safety is very important.
Wei Jianying : past that pharmacist to " ;medicine ,hair on human " ;,these things on the line ,but in recent years ,in pharmacists on patient medication guide ,medication education is getting higher and higher.
From abroad, pharmacists are graded ,what personnel responsible for the deployment ,what people Responsible for pharmacy and medicine it is expressly ,so I think the prescription management way also conform to the historical trend of the times ,with the rest of the world ,so that gradually require us to pharmacy staff more standardized .
The generic name prescribing will increase the workload of doctors host: in the new prescription management method in specific provision, prescription drug use in the generic name to write ,does director Xu ,from single Chinese characters of point of view, common name than the name of commodity is much longer ,and there are many word is more difficult to write the word ,the doctor in the process of work is it right? Will be affected ?Xu Peng :This is in the affirmative, first from the implementation of the new approach to the two week of the situation, as the hospital management department ,first must carry out health department file spirit .
Second ,we also did some work with us ,including our hospital pharmacy departments responsible comrades one piece from the various sections of the reality, do more fine point. For example, the drug name common name and trade name between the control ,including some of the cards or printing some of the sections of commonly used medicine ,has a standard, so the doctor more quickly familiar with them Business.
Objectively speaking ,there are indeed some drug generic name is not used for a long time ,with trade name ,the name is quite long, and some are very complicated ,so the doctor also increased the workload of large ,short time is prolonged patient waiting time, but the long term for patients and favorable ,all with the common name ,just like he said ,involve consultation will save a lot of things .
The prescription more standardized ,reasonable is a good thing ,but now do to Beijing medical staff is great pressure ,because now the patient volume is very large, from this point of view we borrow this opportunity is with the majority of patients also say sorry ,try to understand us, that we may in future work more benefits .
From the patient the future know what they are eating medicine ,for himself as well. I think it should be more advantageous. General name prescription will let the patient cannot read what the host: and we Sohu Health before it is also done on the prescription of survey ,11.
9% of the peoplethey think doctors prescribe some cannot read the reason is a genus of In the name of the drug is too professional ,especially we use the generic name may later they feel more professional ,for our doctors will give patients this aspect of interpretation will also have some pressure ?Xu Peng: like the prescription management way out, we start from the administrative department to do this work ,but also requires us to medical personnel with interpretation of the patient ,the medical staff has been actually did so ,explain the patient to understand .
As mentioned in some professional agents ,may understand patients is difficult ,because after all, is a more professional stuff ,all trades and professions have this problem ,I think this over to the recognition of the disease ,for this drug awareness may gradually understand .
Li Dachuan :generic name prescribing ponder over Li Dachuan :I add a few points: first ,in general after the patients can understand .The Ministry of health physicians in the patients as much as possible to communicate, as close as possible to the drugs were about second .
Medical institutions ,we advocate conditional a pharmacist counseling counter. Third ,SFDA required drug packaging with a generic name. Another Aspects ,commodity name ,sometimes of a patient with a misleading name ,see this drug seems to treat this disease ,but there are other problems ,patients may be somewhat misleading, ask a doctor must be open to anything ,or that what medicine is effective .
Medication is actually a very complex process ,physician selected articles ,pharmacists to guide ,in addition to patients about drugs ,can also pass through manual and many other channels to understand, I think at least not for the patients which damage the interests of the commodity name ,changes into the generic name.
Just say doctors change also needs a process ,but through our grasp of the situation, these are the behoove .Another case, the Ministry of health also is now trying to find some habits of study ,is that some drug name although not universal ,but patients ,physicians ,national recognition ,written after no discrepancy ,similar to the name of some medicines health department in the investigation and study .
Again,Nike Air Force 1 Low, some doctors reflect common name is very long, writes very time-consuming ,the place, the Ministry of health also in investigation and study, if need be, we specification The abbreviation and published, but never allow myself some referred to hospital and the like.
The host: that is actually the health sector although released this way ,but from the perspective of government or on line medical personnel and patient feedback information. The new regulations reflect the safe ,effective ,economic principle host : it should be said that nearly one paragraph time of our whole medicine industry ,whether it is said before prescribing set or list of essential drugs ,including the prescription management method ,which is expressly or by some supplementary terms behave in a safe ,effective ,economic principle, ask Mr.
Li Dachuan ,from our policy of us, prescription management approach which details can embody these principles ?Ministry of health Li Dachuan Li Dachuan :safe ,efficient ,economy is our country reasonable medication requirements ,rational drug use the concept is the earliest be who carried out, there is a clear definition ,according to our national conditions ,we identified in our country to realize reasonable medication is the goal of safe ,effective ,economic safety is the primary goal .
Medicine .Second validity ,is stressed The patients need to use drugs. Third economy ,we emphasize in the choice of medication at the time of cost-benefit analysis ,it is possible with inexpensive drugs to achieve a therapeutic effect, this is we have been pursuing the goal of clinical pharmacy work .
So we health departments in clinical pharmacy management all policies are the six a word ,including prescription management method is one of the aspects .In 2002, the Ministry of health has sent medical institutions drug management Interim Provisions ,we also recently conducted clinical pharmacist training work ,these are in order to achieve a safe ,effective ,economic goals.
Specific to the prescription management way ,in order to achieve safe ,effective ,economy ,first we emphasize the pharmacy departments full role ,because the pharmacy business examples from the previous drug supply department to the development of pharmaceutical care ,drug department personnel must be involved in the process to use drugs to physicians ,audit and control, medical development is very rapid ,pharmacy progress quickly, a a doctor cannot guarantee that he used all the drugs are reasonable ,we need to check these pharmacy .
We always emphasize on medicine To cooperation ,which has great effect on .Second ,the prescription management way we require the use of the generic name prescribing, before early actually do so ,and later because of such reasons are also useful commodity name prescribing ,but there are many unreasonable places ,for example a generic name can be there are many kinds of commodity name ,different physicians may choose a different commodity ,The return trip - Beijing,so each other in physician consultation process ,in the referral process, will not know a former doctor with what medicine is caused by repeated dosing ,the wrong medicine and so on.
Cause drug-induced injury event ,so we require using the generic name prescribing .Third ,we also mention the prescription evaluation system ,the prescription review specific to medical staff ,pharmacy staff ,administrative staff together, play to collective wisdom on a doctor to undertake evaluating regularly ,find prescription medication unreasonable place ,we take the interventions ,training ,improve business knowledge ,if not the business ability to cause ,but other the ability to cause we will take administrative measures ,such as restrictions on prescribing rights or cancel the prescription right ,such as far as possible to ensure that physicians Reasonable .
This is the prescription management method which emphasizes the safe ,effective ,economic management approach ,of course we mentioned on the procurement of medical institutions drug quality limitation, our current state of quality of medicines and lots of the same product quality ,safety is not a very good security, a generic drugs can have many varieties ,medical institutions choose the more varieties of drug quality problems ,because of damage probability is higher ,physicians in medication may also feel not know what course to take ,so we say hospital variety selection ,selection of good quality ,stable ,economic agents ,as far as possible to ensure safety .
Prescription management method in " a two gauge " ;Moderator :new interpretation of prescription management method since carrying out ,the industry has more of a noun " ;a two gauge " ;.
Mr. Li Dachuan from policy can give us an explanation for a two gauge how understand ?Ministry of health Li Dachuan Li Dachuan :This is mainly the prescription management way .Rules ,we procurement of medical institutions drug use of generic drug procurement ,at the same time on the injection and oral dosage forms cannot exceed two category ,Other forms of restrictions.
For example topical nasal spray ,these are not restricted. Why provides for a category ,as much as possible to consider the doctor medication safety. How to grasp ?Injection may have many varieties ,there may be many specifications ,0.
2 grams,0.3gramsof HH, we asked if injection type ,regardless of what is on the choice of two varieties. Can a water injection ,an injection ,and can also be two are water injection .The oral dosage form also has a lot of ,we request that the two varieties.
This regulation because we have done a lot of research ,including the areas of Beijing and Beijing outside the area. In addition, we for the medication also have a basic grasp of ,that is to say we medical use of drugs ,most of which drugs ,we also know the score ,a combination of hospital economy ,we think the same generic two varieties or even a breed basically to meet the needs of our hospital .
Of course is to take the patient as the center ,we cannot say that the drugs limiting the number of dead ,resulting in no medicine available ,so we also stresses on the special needs of the patients Cardiovascular disease is not restricted.
For example, may have different medicine suitable for different groups of people, the ordinary piece of relatively cheap, but is suitable the crowd not many ,may have need .This time if you think two varieties can situation ,the hospital can also apply for selection of third varieties, we asked after the hospital pharmaceutical committee agreed to use the Department ,apply ,think you really need such a category ,it can increase the category .
So from this perspective, not entirely restricted to die ,but we emphasize the application needs to be able to withstand peer review ,health administrative department or other departments to check the time must have sufficient reason.
As for the special needs of the total, according to experience ,for example, some hospitals ,three hospitals ,and hospitals in Beijing ,Star hospital ,if the hospital general medicine varieties has around 1000 words,about the need to increase breed also is some 10 ,some 20 ,not much .
Because we made investigation, basically be to meet the needs of ." ;a two gauge " ;principle of domestic pharmaceutical enterprises influence host: now breed restrictions can lead to foreign investment enterprise or joint occupation More market ,domestic enterprises will be some fight ?Li Dachuan :the Ministry of health to develop the prescription management way ,objective basis ,starting point is to satisfy the interests of patients ,as far as possible to ensure the quality and safety of drug quality .
We with many product safety is not one hundred percent sure ,last year also produced several phytotoxicity the event ,so we suggested hospital possible control of the use of medicines.
This in many provinces ,many hospitals have been done ,the large-scale ,standardized hospital requires more carefully. Of course we are now two chemicals regulation ,is not to say that a is a domestic is imported, but according to you need, if homebred medicines and chemical reagents can meet the inevitable choice of two varieties is domestic, this area is not restricted .
As to whether or not some of the domestic pharmaceutical production enterprises caused by impact, I think it is hard to avoid ,but low levels of repetitive drug production continue on medical safety ,for we Chinese pharmacy development is not very appropriate.
We hope that after the implementation of prescription management method in enterprises can be more to consider how to improve the quality ,reduce the medical cost .The host :When a certain class of drugs from foreign capital or joint ventures varieties produce monopoly ,Come on.,the domestic some excellent enterprise products have lost their high-end hospital market ,for them, is it right? Or unfair ?Li Dachuan :the drug category choice ,this is completely by the hospital to set, entrance medicine may be a bit high.
,domestic may be cheaper ,the main hospital service populations which ,the decision in the hospital ,we do not require hospital must use of imported drugs prescription management method .
Our main purpose is to guarantee patients ,it is our most the problem of core ,the health department is in charge of National Health Service Work Department ,starting point is to ensure patient safety ,other than prescription management method to solve the problem .
The host: now reports that after the introduction of the approaches to problems ,such as patients get the prescription to the pharmacy, a lot of prescription in pharmacies is not to buy ,this on the prescription management way implementation will be some obstacles ?Li Dachuan :our prescription management method ,including the new prescription management method and the 2004 edition of prescription management way ,are not constrained in Jia said the prescription drain ,Ministry of health permits, but does not limit the outflow of hospital prescription ,is after the prescription must allow patients to take the prescription to the pharmacy to buy medicine ,the health administrative departments have been attitude is clear.
The new regulations promulgated later with health needs standards of local host: now we are also concerned about the masses new topic ,the prescription management way after coming on stage with health insurance which need practice place ?Li Dachuan :health standards more in the drug name ,because we had a lot of is to use the name of commodity, so health care use commodity to do ,now we change the generic name ,health departments may also to adjust .
As far as I know, the country also not too long ago ,many province with a generic name ,health sector is also the generic drug name ,including Shanghai ,Ningxia ,but most are commodities ,insurance agencies to undertake adjustment, now it everywhere in the adjustment ,such as Beijing city is very clear the health department and the Department of Health said that we have to adjust ,in accordance with the common name for pharmaceuticals.
Moderator: transition about the time will be long? Li Dachuan :may depend on medicine Insurance sector ,but the management of prescriptions issued by May February 14th ,there should be a little adjustment ,but this adjustment may be necessary for a process.
Because the whole work is to safeguard the interests of patients ,the temporary difficulties also hope that patients can understand and support. The New Prescription Administrative Policy after the implementation of patient feedback and parties host: three case teachers are a frequently with patients to communicate ,a new prescription management way after the implementation of patient has what feedback ?Wei Jianying :I think this just director Xu said more, since the beginning of the patients did not understand this thing ,from our hospital in April 28th implementation of the prescription management way ,in this before our doctor ,nurse aspects of propaganda ,in which we also increased the propagandist strength ,each window as long as patients are able to go to the place we all put up a notice ,is now to implement a new generic name prescribing ,for what purpose ,hope that the majority of patients are able to understand.
So I think as patients, indeed most of the patients are common, for example the name will not ,we told him to write it back to my doctor to modify the prescription ,or we help The patient to modify the prescription ,mostly majority is understandable, but there is dissatisfaction ,may be opposite to doubt or to hospital complaining ,this is objective existence ,just Mr Li ,Mr Xu also expressed ,want patients to be able to solve this problem .
As our pharmacy ,I think the patient performs general in the process of confusion where where? The past some drugs have been used to the commodity name ,certainly felt that drugs can understand ,partly because he does not know the commodity name corresponding to what is chemical name ,and some chemical name is very professional, he also cannot read ,but now all of a sudden change the common name in the process not only physicians ,pharmacists will need to be familiar with ,patients also need to be familiar with ,now replaced by the generic name ,patients will say what it is what ,I think people also need a familiar with the process.
Including hospitals in the implementation process ,the unified a generic name has two drugs ,sometimes special circumstances need three drugs or four ,it is a special reason, the drug will be approved .
So the doctor prescribing process need to mark the drugs exactly which specifications ,which manufacturers . as patients had a drug habit of eating A factory ,now let him eat B plant ,may require an adjustment process ,patients need to understand ,the doctor also hope that the patients get his desired drug ,as a pharmacist is more explain ,hope that the patient can understand ,so we must now be more complicated.
In the process of implementation ,and the drug generic name can reduce error, but in the process also results in some errors in the process. For example common name to it ,I first reflected to this common name is which manufacturer of pharmaceuticals, specification is a number ,accounting personnel have drawn on ,prescription is consistent, so the doctor need to be checked .
In particular, this time also has certain error ,but this thing I feel with the phase transition of the continuous implementation of reducing these. Moderator: like I just said Mr. Li ,our health departments in this process should also consider these factors .
From the Ministry of health in the grasp of the situation, should say the official version issued have been half a month we all the is it right? What are some feedback from medical institutions ,Air Foamposite 1 class status,is this ?Li Dachuan: world that is the case ,now Prescription management method all are actively implementing the ,more likely to prepare, hospitals have to prepare, may be on physician training ,nurses should master .
In addition ,in accordance with the requirements of the doctor institutions to drug selection ,in addition to the new prescription management method has some changes ,adjust the requirement of hospital management .
After the implementation of national ,uneven ,some doctors ,some places may be relatively early start test of the generic system ,transition smoothly point ,but it is my master they started doing it also through such a cycle ,some places may be because no such basis ,may be more difficult one point ,the hospital ,the administrative Department of public health ,hospital doctors ,toll there are difficulties ,but overall these things are gradually resolved ,physicians ,pharmacists to the universal acceptance, patients on universal acceptance, should say on the whole is balanced ,no problem too big Moderator :two years .
This should say hospital many drugs we are through drug bidding system ,our products now there may be some adjustment ,to bidding the how to combine ?Li Dachuan :I feel tender is according to the hospital need what drug to tender ,we require hospitals to formulate prescription ,the prescription management method is provided ,the prescription of decided their drug supply catalog ,in accordance with the supply of the directory to undertake invite public bidding, that is my hospital need to purchase which drugs according to its tender ,invite public bidding is according to the catalog .
Moderator: according to this time our prescription management method ,should be said that in addition to hospital with a number of outside ,still ask our hospital because the hospital does not like, for our own hospital do a directory ,Handbook ,our hospital is how to do ?Wei Jianying :as our hospital this is just like a catalogue ,Mr.
Li said, we want to formulate their own basic directory ,before we strict implementation of prescription management method ,because the hospital basic medicine catalogue is composed of pharmacy will have to decide, we will open a pharmacy ,to drugs such as antibiotics to clean ,I think not too many reasons for more than 2of course,with the exception of varieties ,pediatric ,there are a number of individual cardiovascular with some exceptions ,so we will determine the form of hospital pharmacy Basic Medicine Moderator :catalogue .
Should say like this hospital is more normative ,besides some varieties ,adidas Jeremy Scott Wings,may is generally in two varieties .Wei Jianying: Yes ,more than 2 varietiesmore than our hospital to look, there is a total of 20 groups,20 groupsinside a lot in this drug is clinically necessary for example ,nasal spray ,breathing ,and ophthalmic drugs ,such as injection ,is really different concentrations ,as clinical are a must, as these species I think are reasonable ,there are very few varieties belong to should be deleted .
Moderator: we noticed the new prescription management method for medical staff themselves these qualities also have some requirements ,we know some teaching hospital ,may prevail in outpatient clinic by students to write prescriptions ,http://adidasjeremyscottit.com,signature ,or in the inpatient department ,some graduate students ,doctoral students ,learning such as the doctor in patient management, a new prescription management method to these situations has those limit ?Li Dachuan :prescription management method third chapters are devoted to speak ,which in addition to speak normal occupation and occupation physician physician assistant obtained in the case ,and told doctors prescribing rights acquisition ,Refresher physicians through medical institutions where examination can obtain prescription right ,this is reaffirmed the provisions.
On graduate students ,doctoral students ,this matter itself registered and approach has the explicit stipulation ,is that physicians must get the doctor qualification after occupation registration ,in accordance with the registered place of occupation ,occupation and occupation background research practitioners .
Students are students ,not the true meaning of the doctor ,so there is no registration, these people we always only in occupation physician guidance engaged in medical ,can work together with physicians ,prescribing after need occupation doctor qualification to sign ,he is a student ,he must have the occupation physician to guide he needed in his work ,occupation physician recognition .
The host: that is to say we were seen in two of the time signature ,attention must be paid to the back is as long as he is occupation physician can .Li Dachuan: Yes .Xu Peng :prescription management method with the physician called " ;qualifications or " ;" ;" prescription eligibility ;validation is not contradictory, without qualification or no prescription right is unable to practise medicine ,prescription .
Moderator: Pharmacists on prescription supervisory body Now where ?Wei Jianying :prescription management method in different periods have different requirements. The new prescription management method requires pharmacists to prescription audit audit ,he what ?The first is to write is in accordance with the prescribed requirements specification ,this of course is very simple ,the most important I think for prescription rationality as audit .
Pharmacists who found prescription errors or when in doubt ,need timely inform physicians ,and physician communication ,has the obvious errors when the pharmacist is the right to direct proofreading .
New prescription management method which adds a ,in you to inform physicians and pharmacists are to be recorded ,mostly in order to reach the hospital monitoring purpose. Now we understand our hospital do ,of course do not remember many ,also recorded about this prescription pharmacist what work .