- 期刊
降低慢性復健病房藥品異常補藥率之專案
Reducing the Rate of Abnormal Replenishment of Drugs in Chronic Rehabilitation Wards
摘要
復健病人服用藥物種類多，給藥過程發生藥品異常補藥，導致病人用藥延遲，增加藥物疏失風險，本單位2019年5月藥品異常補藥率為4.1%，高於2018年年平均藥品異常補藥率為2.4%，亦高於同年1月至4月月平均藥品異常補藥率1.9%，因而引發專案改善動機。本專案目的為降低慢性復健病房藥品異常補藥率，經由統計報表、人員訪談及實地查檢發現，造成藥品異常補藥率高的原因為：護理師未落實對藥流程、磨粉時藥物掉落、系統切帳藥物餘量不足、病人床旁桌凌亂，造成藥杯掉落及服藥過程掉藥、冰箱筆型胰島素堆疊擺放凌亂。解決辦法經由翻轉教學導入正確給藥教育、創新製作防彈研缽蓋、調整資訊系統、規範床旁桌及筆型胰島素擺放、舉辦病人團體衛教等實施後，藥品異常補藥率由改善前4.1%下降至1.2%，已達到專案目的，此專案結果可作為慢性病房預防藥品異常補藥之參考。
並列摘要
Rehabilitation patients often take many kinds of drugs and abnormal replenishment of drugs during the administration process, which increases the risk of medicine errors. In our apartment, the rate of abnormal replenishment of drugs was 4.1% in May 2019, higher than the rate of abnormal replenishment of drugs of 2.4% in 2018, and also higher than the rate of abnormal replenishment of drugs of 1.9% from January to April in 2019, thus triggering our motivation for improvement. The purpose of this project was to reduce the rate of abnormal replenishment of drugs in chronic rehabilitation wards. According to statistical reports, personnel interviews and on-site inspections, our analysis suggested that abnormal replenishment of drugs was mainly caused by the nurses without implementing the medication process, the medication drop during powder grinding, the system accounted for insufficient medication, the patient's bedside table in a mess, causing the medication cup to fall during the medication process, and the refrigerator insulin pen stacked disorderly. The solutions were through flipping teaching to correct drug delivery education, innovatively making production of bulletproof mortar covers, readjusting the information system, standardizing the placement of bedside table items and insulin pen, and conducting patient health education. The abnormal replenishment rate of rehabilitation wards decreased from 4.1% to 1.2%. Overall, the project goal was achieved. The results can serve as a reference to prevent abnormal replenishment of drugs in chronic wards.