中文摘要 論文名稱:影響醫師開立門診異常處方之原因探討—以北區某區域教學醫院為例 研究所名稱:臺北醫學大學醫務管理學系碩士在職專班 研究生姓名:羅文傑 畢業時間:九十六學年度第二學期 指導教授:黃國哲 臺北醫學大學 醫務管理學系 副教授 醫師能夠開立正確處方是防止病人用藥錯誤的重要關鍵因素,若是能夠使醫師開立處方時減少錯誤,則病人用藥安全可謂向前邁進一大步。本研究目的有以下兩點:(一)、瞭解門診病人藥品處方異常的型態,並探討發生異常處方的可能因素;(二)、提出如何在現行病人用藥安全管理制度下,可以減少處方錯誤,以期病人的用藥安全可以獲得更多的保障。 本研究以北部某區域教學醫院於民國九十四年之門診藥物資料檔及醫師資料檔進行分析,以探討醫師因素、病人因素及藥品因素對於異常處方之影響力。 研究結果顯示,『醫師總治療門診病患人次』、『該次診療為慢性病』及『用量』的影響力達統計上的顯著意義,也就是醫師總治療門診病患人次越多,或該次診療為慢性病,則比較容易出現異常處方。此外,藥品用量輸入錯誤對開立異常處方也有顯著性的影響力。 建議改善醫師看診方式及休息時間的安排,並鼓勵慢性病病人多利用慢性處方箋,及加強開立藥品流程的把關及藥品辦識系統的改善,如此一來將可減少異常處方的開立,有效提高用藥安全。 關鍵字:異常處方、慢性處方箋、用藥安全
Abstract Exploring the Causes Influencing Physicians’ Incorrect Prescriptions For Outpatients—Taking One Northern Regional Teaching Hospital As an Example Author: Wen-Jie Luo Thesis advised by: Kuo-Cherh Huang, Dr.P.H. A correct prescription by a physician is the main factor to prevent a patient from using incorrect medicines. Less mistakes of physician’s prescriptions will provide more safety for patients while taking medicines. There are two purposes of this research. The first purpose is to examine the type of unusual prescriptions and possible causing factors of those prescriptions. The second purpose is to address the way to reduce incorrect prescriptions for patients under current safety management system. The present study was to explore the databse of the outpatient deparment in one northern regional teaching hospital. In order to explore the factors regardingn incorrect prescriptions. The results showed “the number of people in outpatient department treated by a doctor”, “diagnostics for chronic disease”, and “dosage of medicine”significantly influenced incorrect prescriptions. In addition, wrong dosage of medicine was also found to impact incorrect prescriptions. Finally, following ways are proposed to reduce the rates of incorrect prescriptions and increase the drug safety : introducing a break time for doctors; encouraging chronic patients to make the best use of long-term prescriptions ; for enhancing the procedure of writing prescriptions ; and improveing the identification system of medicine. Keyword: incorrect prescriptions、long-term prescriptions、drug safety