建立物理因子治療的電腦警示系統以增進病患安全

本研究的目的在於有系統地探討與分析目前國內物理因子治療項目開立時，患者可能存有該物理因子治療項目禁忌症的情形，並嘗試建置「物理因子治療項目禁忌症警示系統」，用於可能禁忌症的偵測與預防。此系統亦可應用於醫學教育訓練之用途。本研究整理了物理因子治療項目的禁忌症，並將禁忌症分類，規劃並建置復健科診間禁忌症警示系統，經由過去病史的分析，以得知目前接受物理因子治療的病人是否可能存有該項治療禁忌症的狀況。本研究顯示，接受物理因子治療的病人中，依照患者病史，有25.5%的項次可能具有該項治療的禁忌症，然而或許因為禁忌症影響部位與治療部位的區隔，並沒有真正發生這麼多的醫療錯誤。透過資料庫的分析與整理以及禁忌症警示系統的使用，將來我們可以更瞭解醫師在患者可能有禁忌症存在時，對物理因子治療項目的處方態度，藉以修正臨床運作的流程，預防可能的不良反應以增進病患的安全。

關鍵字

病患安全；復健資訊系統；物理因子治療；禁忌症

並列摘要

This study investigated and analyzed the prevalence of contraindications that can co-exist with a prescribed physical agent. To prevent likely complications, this study implemented a computer warning system, which prompts physiatrists to possible contraindications. Once a physical agent is prescribed, the system automatically reviews the ICD-9 codes in the patients’ medical chart. Two pre-established databases are used in the warning system: one contains contraindications for each physical agent and the other has possible contraindications for each selected ICD-9 code. By cross-referencing between ICD-9 codes in a patient's chart and the two databases, the warning system was able to identify possible contraindications for physical agents prescribed. Statistical analysis showed that there were possible contraindications for 25.5% of all physical agents prescribed. However, the affected body part for a contraindication may differ from the treatment site. Consequently, few medical adverse events occurred. In conclusion, the data collected and the proposed computer warning system implemented in the study promotes patient safety and will likely prove useful to medical education.

並列關鍵字

patient safety ； rehabilitation information system ； physical agents ； contraindications

國際替代計量

建立物理因子治療的電腦警示系統以增進病患安全

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