Ukukhethwa Kwemithi Ezibhedlela
I-formulary yesibhedlela iwuhlu lwemithi ekhethiwe evunyelwe ukusetshenziswa esikhungweni sezempilo, egcwele imiyalelo yokusetshenziswa kanye nolwazi olusekelayo. I-formulary ingaphezu nje kohlu lwamagama emithi; iyithuluzi elibalulekile lokuqinisekisa ukwelashwa okunengqondo, okuphephile, okusebenzayo, nokungabizi. Phakathi kobunzima obandayo bezifo, izinhlobo eziningi zemithi, kanye nengcindezi yokufeza ukusebenza kahle kwezindleko, inqubo yokukhetha imithi ngaphakathi kwe-formulary iyisisekelo esibalulekile sokuphathwa kwekhemisi lezokwelapha kanye nokuphathwa kwemithi ezibhedlela.
Incazelo kanye nenhloso yefomulari
I-formulary ingumphumela wesinqumo esihlangene, esivame ukuphathwa yiKomidi Lezemithi Nezokwelapha (PCH) noma ithimba elifanayo. Izinhloso zayo zifaka: (1) ukuthuthukisa ikhwalithi yokunakekelwa ngokukhuthaza ukusetshenziswa kwemithi ngokusekelwe ebufakazini besayensi, (2) ukugcina ukuphepha kwesiguli ngokulinganisa ukwelashwa nokunciphisa ukuhlukahluka okungadingekile, (3) ukuqinisekisa ukutholakala kwemithi ebaluleke kakhulu ehlobene namaphethini ezifo zasendaweni, kanye (4) nokulawula izindleko ngaphandle kokubeka engcupheni imiphumela yezokwelapha. Nge-formulary, izibhedlela zingavumelanisa imikhuba yezokwelapha phakathi kodokotela, zenze kube lula ukuthengwa kanye nokuhlela isitokwe, futhi ziqinise izinhlelo zokulawula ukumelana namagciwane.
Izimiso eziyisisekelo zokukhetha izidakamizwa
Ukukhethwa kwemithi efomini kufanele kube ngokufanele kusekelwe ezimisweni zokusetshenziswa kwemithi okunengqondo. Lokhu kusho ukuthi imithi ikhethwa ngenxa yezinzuzo zayo ezicacile kanye nezingozi ezingalawuleki, hhayi nje ngokusekelwe emkhubeni, ekukhushulweni, noma ekuthandweni komuntu ngamunye. Izimiso ezivame ukusetshenziswa zifaka: ukusebenza kahle kwezokwelapha okuqinisekisiwe, ukuphepha, ikhwalithi yomkhiqizo, ukulula kokusetshenziswa, ukutholakala kwamafomu omthamo afanele, ukuhambisana neziqondiso zezokwelapha, kanye nokusebenza kahle kwezindleko. Ngaphezu kwalokho, ukukhetha kufanele kucabangele izidingo zeziguli zesibhedlela—isibonelo, isibhedlela sokudlulisela esinamacala ayinkimbinkimbi sizodinga uhla olubanzi lwemithi kunesibhedlela esinikeza izinsizakalo eziyisisekelo.
Indima Yekomidi Lezemithi Nezokwelapha
IKomidi Lezidakamizwa Zefomula (i-KFT) liyiyona nto eyinhloko eqhuba ukukhethwa nokuhlolwa kwemithi yefomula. Amalungu e-KFT ngokuvamile ahlanganisa odokotela abavela emikhakheni eyahlukene, osokhemisi, abahlengikazi, kanye nabasebenzi bokuphatha. I-KFT inomsebenzi wokwakha izinqubomgomo, ukuhlola iziphakamiso zemithi emisha, ukuqapha ukusetshenziswa kwemithi, kanye nokuhlola ukuphepha ngokubika izehlakalo zemithi emibi. Izinqumo ze-KFT kumele zibe sobala futhi ziqondiswe idatha. Ukungqubuzana kwezintshisekelo kudingeka kulawulwe, isibonelo ngokumemezela ubudlelwano nemboni yemithi kanye nokunciphisa ukubandakanyeka ekukhetheni imithi ethile.
Izigaba zokukhetha imithi: kusukela esidingweni kuya esinqumweni
Inqubo yokukhetha imithi ngokuvamile iqala ngokuhlonza isidingo. Izibhedlela zihlola amaphethini esifo, amaphrofayili eziguli (abantwana, asebekhulile, asebekhulile), kanye namazinga enkonzo (i-ER, i-ICU, isiguli esingalaliswa esibhedlela). Isinyathelo esilandelayo isiphakamiso semithi esivela kudokotela noma iyunithi yesevisi, esihambisana nokuqinisekiswa kwezokwelapha. Lokhu kulandelwa ukuhlolwa kwezincwadi: izivivinyo zezokwelapha, ukuhlaziywa kwe-meta, iziqondiso zezokwelapha zezwe nezamazwe ngamazwe, kanye nedatha yangempela, uma ikhona.
Ngemva kwalokho, kuhlolwa izici zokuphepha: imiphumela emibi, izixwayiso ezikhethekile, ukusebenzisana kwezidakamizwa, izingozi zokukhulelwa noma ukuphazamiseka kwezitho zomzimba, kanye namaphutha emithi angaba khona ngenxa yokufana kwegama/iphakheji. Okulandelayo, kuhlolwa izici zemithi—ukuzinza, ukuhambisana nokuxuba, izidingo zokugcina uchungechunge olubandayo, kanye nokutholakala kwamafomu omthamo (amaphilisi, imijovo, amalungiselelo ezingane). Kulapho-ke kuphela lapho kwenziwa khona ukuhlolwa kwe-pharmacoeconomic, isibonelo, ukuqhathanisa izindleko zokwelapha ngosuku, izindleko ngomphumela ngamunye wezokwelapha, noma ukuhlaziywa komthelela wesabelomali ukuqinisekisa ukuthi isibhedlela singawuhlinzeka umuthi ngendlela eqhubekayo.
Izindlela zokusebenza kahle kanye nezindlela ezisekelwe ebufakazini
Ukusebenza kahle kuyisici esibalulekile. Imithi efakwe ku-formulary kufanele ibe nobufakazi obuqinile benzuzo enkombeni efanele. I-KFT ivame ukuhlola ukuthi umuthi omusha unikeza yini inzuzo enenjongo kunokwelashwa okujwayelekile: ukwandisa amazinga okwelapha, ukunciphisa ukufa, ukunciphisa isikhathi sokuhlala, noma ukuthuthukisa ikhwalithi yokuphila. Imithi ethi “Me-too” enganikezi izinzuzo ezibalulekile zezokwelapha ngokuvamile ayibekwa phambili ngaphandle kokuthi kunezici ezithile ezifana nephrofayili yokuphepha engcono noma isidingo seqembu elithile labantu.
Ukuphepha kwesiguli kanye nokuvimbela amaphutha emithini
Ukuphepha kwesiguli kuyinto okufanele icatshangelwe. Imithi eqaphile kakhulu (isib., ama-anticoagulant, i-insulin, ama-opioid, i-chemotherapy) idinga izinqubomgomo zokusetshenziswa eziqinile, njengemikhawulo yezinkomba, izinqubo zokulinganisa umthamo, kanye nokuqapha. Ukukhethwa kwemithi kumele futhi kucabangele amaphutha emithi ngenxa yemithi efana nomsindo (LASA). Izibhedlela zingakhetha uhlobo olulodwa noma ifomu lomthamo ukunciphisa ukudideka, kanye nokuhlinzeka ngamalebula esixwayiso kanye nezinhlelo zokusekela izinqumo zezokwelapha ze-elekthronikhi.
Izinto ezicatshangelwayo kwezomnotho kanye nokusimama kwesabelomali
Izindleko aziyona nje intengo yeyunithi yomuthi, kodwa yizindleko eziphelele zokwelapha. Imithi ebiza kakhulu ingase ikhethwe uma inciphisa izinkinga, inciphisa isidingo sezinqubo zokulandelela, noma ifinyeze isikhathi sokuhlala. Ngakho-ke, ukusebenza kahle kwezindleko kanye nokuhlaziywa komthelela wesabelomali kuya ngokuya kuba yinto ebaluleke kakhulu. I-F&B kanye nabaphathi bavame ukuhlanganisa idatha yokusetshenziswa komlando, amanani enkontileka yokuthenga, kanye nokubikezela kwenani leziguli. Esikhathini sokuxhaswa ngezimali okusekelwe ephaketheni noma okusekelwe esimangalweni somshuwalense, ukukhetha umuthi ofanele kungasiza izibhedlela ukugcina ikhwalithi yesevisi kanye nokuzinza kwezezimali.
Ukulinganisa, imikhawulo, kanye neziqondiso zokusetshenziswa
Ifomula elihle lihlanganisa iziqondiso zokusetshenziswa. Akuzona zonke izidakamizwa okufanele zinikezwe mahhala ngaphandle kwemingcele. Eminye imithi ingase ivinjelwe, njengemithi yokwelapha yomugqa wokugcina, edinga imvume evela kudokotela othile noma eqenjini lohlelo lokulawula ukumelana namagciwane (ubuphathi). Izinqubomgomo zokwelapha ngesinyathelo nazo zidinga ukusetshenziswa kwemithi yomugqa wokuqala ngaphambi kokudlulela emithini ebiza kakhulu noma enobuthi, ngaphandle kokuthi kungavunyelwe. Lokhu kuhlanganiswa kusiza ukugcina ukuhambisana kokwelashwa futhi kunciphisa ukusetshenziswa okungafanele.
Ukuhlolwa nokuphathwa kwezidakamizwa eziphumayo njalo ngezikhathi ezithile (ukususwa ohlwini)
Ukukhethwa kwemithi akuyona inqubo eyenzeka kanye kuphela. Ifomula kumele ihlolwe njalo. Imithi ingasuswa uma ingasebenzi kahle, ibangela ukukhathazeka ngokuphepha, ingasatholakali, noma uma kutholakala ezinye izindlela ezingcono. Idatha esetshenzisiwe ifaka phakathi amaphethini okunikeza imithi, ukuhlolwa kokusetshenziswa kwemithi, imibiko yemiphumela emibi, ukuhambisana neziqondiso, kanye nokuhlolwa kwezindleko. Lokhu kuhlola kuqinisekisa ukuthi ifomula ihlala ifanelekile futhi isabela ekuthuthukisweni kwesayensi yezokwelapha kanye nezimo zokusebenza esibhedlela.
Ukuqaliswa: ukwesekwa kohlelo kanye nemfundo
Ifomula elihle lizohluleka uma lingasetshenziswa kahle. Izibhedlela zidinga ukuqinisekisa ukuthi kukhona imithi ebhalwe ohlwini, uhlelo lokuthenga oluzinzile, kanye nokusekelwa kobuchwepheshe njenge-Computerized Physician Order Entry (CPOE) noma i-e-prescribing ehlanganiswe nefomula. Imfundo yodokotela, osokhemisi, kanye nabahlengikazi nayo ibalulekile ukuqinisekisa ukuthi ukwelashwa kunamathela ezindinganisweni. Ngaphezu kwalokho, ukuxhumana ngezinqubomgomo zokufaka esikhundleni ezijwayelekile, ukusebenzisana, kanye nezinqubo zokucela imithi engeyona eyefomula kumele kucace ukuze kugwenywe ukuphazamiseka kokulethwa kwezinsizakalo.
Izinselele ekukhetheni izidakamizwa
Ezinye izinselele ezivame ukuvela zifaka phakathi ukwehluka kokuthandwa odokotela, ingcindezi yokusebenzisa imithi emisha, ethandwayo, ukukhushulwa kwemboni, imikhawulo yesabelomali, kanye nezinkinga zochungechunge lokuhlinzekwa. Enye inselele izidingo zamacala akhethekile angeke avunyelwe njalo ngemithi ejwayelekile. Ngakho-ke, izibhedlela zidinga indlela esheshayo kodwa elawulwayo yemithi engeyona eyefomula, njengokuvunyelwa kwe-KFT noma abeluleki abahlobene nokuqinisekiswa kanye nokuhlolwa kwangemva kokusetshenziswa.
Isiphetho
Ukukhethwa kwemithi efomini yesibhedlela kuyinqubo ehlelekile ehlanganisa ubufakazi besayensi, izinto ezicatshangelwayo zokuphepha, isidingo somtholampilo, kanye nokonga izindleko. Ngokuphathwa okuqinile nge-Quality of Drugs (KFT), izindlela zokukhetha ezicacile, ukuhlolwa okuvamile, kanye nokusetshenziswa okuqhubekayo, ifomini ingathuthukisa ikhwalithi yokwelapha, inciphise ukushintshashintsha okungadingekile kokunikeza imithi, futhi ivikele iziguli ezingozini zemithi. Ekugcineni, ifomini ephethwe kahle iyinsika ebalulekile yezinsizakalo zezempilo ezisezingeni eliphezulu, eziphephile, nezisimeme ezibhedlela.
