- 期刊
醫療院所電腦處方開立疏失探討
Computerized Medication Prescribing Frrors in Hospital Settings
摘要
目的：目前各醫療院所皆朝向醫囑電腦化的目標前進，主要目的除了可以減少人為輸入錯誤外，並可以即時啟動相關作業系統，達到縮短等候時間的優勢。但由於一些人為及環境困素造成電腦醫囑不當開立後隨即遭到刪除，導致醫囑電腦化的美好構思無法發揮其原本功能，反而造成相關業務單位不必要的業務增加；除此之外，亦會影響醫院的營運績效與醫療服務品質。材料與方法：將台灣某區域教學醫院九十一年一月至三月所有當日開立即於24小時內刪除之住院電腦處方（但不包括首日量沒有滾量的處方），納入統計分析。結果：九十一年一月至三月住院電腦處方共有20,132張，當日開立即於24小時內刪除處方件數共為7,364件，發生比率為37%。結論：處方的開立及刪除由醫師視病患臨床需要做出應有的變動，但根據該區域教學的經驗，其院內一般電腦處方當日開立即於24小時內刪除大都源自於人為疏忽及操作不當。各醫療所應該針對院內此類似異常事件進行探討，確實分析問題癥結所在並擬定對策加以改善，以便達到降低人力成本、降低人員作業負擔、及最佳的營運效益與醫療品質。
並列摘要
Objective: Most health care institutes are moving toward the development of computerized prescribing system to decrease order entry errors, initiate a concurrent related working system; and decrease waiting times. However, due to personal and working environmental factors, some computerized prescriptions are prescribed and shortly deleted within 24 hours. These medication prescribing errors not only increase the workload of related professionals, but also render the computerized prescribing system sub-functional. In addition, the health care performances and medical service qualities of institutes are degraded. Materials and Methods: All computerized prescriptions prescribed from January to March of 2002 were collected and analyzed from a regional teaching hospital in Taiwan. Results: In totals there were 20,132 computerized prescriptions ordered, among which 7,364 prescriptions were prescribed and deleted within 24 hours, for an occurrence rate of approximately 37%. Conclusions: Based on a patient’s clinical needs, a physician may change orders for a patient if necessary. But. According to the experiences of this regional teaching hospital, many computerized prescriptions are prescribed inappropriately due to poor personal computer operating skills. In order to prevent medication errors and improve medical service qualities, health care institute managers should look at these incidences as an important issue which should be addressed.