- 期刊
降低某醫院靜脈化療藥品給藥異常發生率之改善專案
Project to Reduce the Incidence Rate of Intravenous Chemotherapy Drugs Administered in a Hospital
摘要
化療藥品為高警訊藥品，其給藥過程較一般藥品繁複，若有不慎，可能會導致潛在性病人安全問題。統計2011年及2012年護理師靜脈化療給藥異常發生率由0.004%（3件）提升至0.008%（8件），顯示靜脈化療給藥異常發生率有增加的趨勢。此外，由於化療給藥流程較一般給藥繁複，臨床上也常聽到護理師抱怨化療給藥因耗費較多時間，所以過程易被中斷。故本專案旨在提升化學治療給藥安全，並縮短護理人員化療給藥時間。針對某醫院化療給藥異常資料進行分析及訪談，並觀察護理師執行化療給藥過程，確認主要問題為護理師流速計算錯誤、幫浦設定錯誤、未落實複核。透過條碼藥品給藥系統、簡化給藥流程及教育訓練等方案，化療給藥異常發生率由0.008%下降至0.003%，每筆化療給藥時間也節省了82秒，對使用條碼藥品給藥系統的滿意度也由77.8分上升至83.2分。
並列摘要
The chemotherapy drugs are highly cytotoxic, which damage all the cells of human and not just the cancer cells. Medication errors are a serious threat to chemotherapy patients. The demand for chemotherapy increases each year and the chemotherapy administration incidence rates have also increased. Statistics for 2011 and 2012 in a hospital have shown a climb in the chemotherapy IV administration incidence rate from 0.004% (3) to 0.008% (8). It was also noted the complex process in administering the IV medications has resulted in the lengthy and interrupted administration time. This project aimed to secure the safety in intravenous chemotherapy administration, reduce the incidence rate and shorten the time of IV administration. We analyzed the chemotherapy administered incidence events, interviewed nurses, and observed nurses during the IV administration process of chemotherapy. The major problems identified were calculation error in the flow rate, the inaccurate pump setting, and absence of double checking. The implementation of barcode administration system, simplified administration procedures, and educational training programs drove the incidence rate of IV chemotherapy administration down from 0.008% to 0.003%; the chemotherapy administration time was also shortened by 82 seconds each. Satisfaction of the medication barcode administration system also rose from 77.8 points to 83.2 points.
參考文獻
延伸閱讀
- 蔣曉文、樊君儀、張雅嵐、洪世欣（2013）。降低靜脈輸液化學藥物外濺發生率專案。榮總護理，30(4)，407-416。https://doi.org/10.6142/VGHN.30.4.407
- 陳昭惠、莊冠琪、林莉莉、李婉琳、藍伯媖、李雅惠（2016）。縮短住院化學治療病人等待化學藥物注射時間之改善專案。馬偕護理雜誌，10(2)，16-26。https://doi.org/10.29415/JMKN.201607_10(2).0002
- 陳欣華、黃杏娟、楊美華、胡靜文、嚴美華（2022）。降低慢性復健病房藥品異常補藥率之專案。新臺北護理期刊，24(2)，96-107。https://doi.org/10.6540/NTJN.202209_24(2).0009
- 任惠慈、康瑞蘭、方惠珊、鄧慶華（2015）。心臟血管病房護理人員執行靜脈藥物劑量計算之改善方案。長庚護理，26(4)，425-437。https://doi.org/10.3966/102673012015122604005
- 呂詩敏、謝佩真、紀淑真（2021）。Project to Reduce the Venous Catheter-Related blood Infection Rate in the Medical Ward。彰化護理，28(3)，49-64。https://doi.org/10.6647/CN.202109_28(3).0008