頁籤選單縮合
題 名 | 腫瘤科化療醫囑電腦化系統改善專案=Proposal for Improving the Computerized System of Chemotherapy Order by Oncology Department |
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作 者 | 林怡欣; 張玉珠; 張獻崑; | 書刊名 | 腫瘤護理雜誌 |
卷 期 | 9:1 2009.06[民98.06] |
頁 次 | 頁37-48 |
分類號 | 418.98、418.98 |
關鍵詞 | 複方化學治療; 處方錯誤; 用藥安全; Chemotherapy regimen; Prescription error; Medication safety; |
語 文 | 中文(Chinese) |
中文摘要 | 化學治療在腫瘤治療中佔有重要角色,且多為複方處方,故處方開立時須小心謹慎考量多重因素。臨床曾因開立化療醫囑處方疏失,引發化療副作用之不良事件的通報,所以為了用藥安全稽核,在北區某醫院化療藥局2006年12月該月統計資料顯示腫瘤科化療處方電腦化作業錯誤率高達17%,發現住院醫師對『複方化學治療』及『化療醫囑』系統不熟悉,以致開立化療處方容易發生錯誤,增加聯絡修改處方的時間,影響醫師、護理人員與藥師等相關人員的作業,並影響病患接受化療的安全,因而設立此專案,以方便取樣內科住院醫師33人作為調查對象,以百分比計算統計並描述結果。有效改善化療醫囑電腦化作業系統之策略以(1)熟悉專科醫療與臨床實務作業之專科護理師,與電子網頁設計專業資管人員研訂檢討化療醫囑範本之建立與簡化操作流程;(2)使用者之在職教育與宣導為重要關鍵,結果呈現腫瘤科化療處方錯誤率由17%降至1.3%,內科住院醫師開立化療處方錯誤降低,且使用電腦『化療醫囑』系統的滿意度由2.24提升至4.42,此專案改善確實能提高開立化療處方的正確率及方便性,並提昇用藥安全及醫療品質。 |
英文摘要 | Chemotherapy plays a key role in cancer treatment, and multiple prescriptions are necessary in most of cases, various factors need to be taken into account while prescribing, and the administered dosage have to be calculated carefully. From the statistic data, which are prepared for monitor of medication safety in December, 2006 by chemotherapy pharmacy of the hospital, an error rate made by Oncology Department in using the computerized chemotherapy prescription system was found as high as 17%. A further analysis tells us that the main reasons which lead to resident physician easily making mistake in prescription are unfamiliar with the operation of the computerized 'chemotherapy regimen' and 'chemotherapy order' systems. This will not only take another time for communicating with physicians for correction, but also affect the subsequent works relevant to other physicians, nurses, and pharmacists and threaten the safety of patients receiving the chemotherapy. We, therefore, initiate the proposal to improve the computerized system. For sampling convenience, the all 33 participants are resident physicians from internal medicine. The results of the statistic data are expressed as percentage of participants along with a written description. The strategies for improving the operation of the system are, first, revising and reconstructing the standard format of chemotherapy order and simplifying the operation steps, which are completed by clinical nurse specialist who is familiar with the specialist care and clinical practice in cooperation with the information management professionals who designs the electronic homepage, and, second, organizing in-service user education and system dissemination activities. As a result, the error rate made in operating the system of chemotherapy prescription by Oncology Department decreased from 17% to 1.3% and the error occurrence made in prescribing the chemotherapy medications by resident physicians of Internal Department became lower. Moreover, satisfaction in using the computerized 'chemotherapy order' systems increased from 2.24 to 4.42. We, therefore, conclude that the improving proposal can actually increase the accuracy and convenience in prescribing the chemotherapy medication and promote the medication safety and medical assurance. |
本系統中英文摘要資訊取自各篇刊載內容。