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題名:住院病患藥物配發品質改善專案
書刊名:榮總護理
作者:陳玉枝陳真瑗酒小蕙李碧雲劉宇平溫美容林麗華張玉采
出版日期:1994
卷期:11:4
頁次:頁438-446
主題關鍵詞:藥物配發藥物投予藥物配發不正確Medication dispensingThe error of medication dispensation
原始連結:連回原系統網址new window
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     臨床上給藥正確性是醫療品質的重要指標,本專案針對因醫師開立醫囑由助理人員 輸入電腦傳送處方配藥 ,導致藥局藥物配發問題:(一)藥物配發不正確率佔總配藥數之 4.47%,其中因醫囑與電腦輸入不一致者有2.8%,佔不確率的63%。(二)護理人員因處理藥 物配發不正確的問題是平均每天每病房須時22.25分。自民國83年6月至8月組織改善小組, 掌握狀況,解析原因,確立問題,研擬策略進行改善,目的在經由改進醫囑與電腦輸入之配 合,以達到下列之目的:(一)減少醫囑與電腦輸入不一致發生率;(二)減少住院病患藥物配發 不正確率;(三)節省護理人員在處理藥物配發不正確的時間。結果顯示:(一)藥物配發不正確 率由4.47%減為2.37%;(二)醫囑與電腦不一致發生率由2.8%減為1.12%;(三)護理人員處理 藥物配發不正確的時間由原來每病房每天22.5分減為7.6分。 本專案對病患藥物配發問題已獲致部份改進,但未臻理想的原因係因系統性政策的問 題,規定非醫師輸入醫囑所致,經本案探討後建議院方做政策性的改變,已獲准改由醫師直 接輸入電腦開立醫囑,將可持續改善藥物配發的品質。
     Administration of medication is the most important quality indicator in clinical practice. The problems of the medication dispensation in this project are: 1) the error of medication dispensation rate 4.47%; the medication order in computer error rate is 2.8%, and the medication order in computer error rate from total medication dispensation is 63%; 2) average time consumption of the nurses in managing the error is 22.25 minutes each unit per day. From June, 1994 to August, 1994, the quality improvement team was organized to collect data, analyze the variation, define the problem and select the problem solving strategies. The purposes of this project were: 1) to reduce the error of medication dispensation rate; 2) to reduce the medication order in computer rate; 3) to save the nurse's time in managing the medication dispensation problems. The problems have been solved. The findings are as follows: 1) Medication dispensation error rate was reduced from 4.47% to 2.37%; 2) the error of the medication order in computer error rate was reduced from 2.8% to 1.12% and 63% of the order in computer error rate was reduced to 50%; 3) the average amount of nursing time saved in each unit decreased from 22.25 to 7.6 minutes each day. The purposes of this project have been accomplished, but the policy on medication order entry to the computer by unit clerks which caused the error remains a systemic problem. The suggestion to change the policy on order entry by the physician was accepted by the hospital administrator. The quality of the medication dispensation will be further investigated.
 
 
 
 
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