- 學位論文
醫院藥師工作環境與知覺的組織社會心理對發生調劑錯誤之相關
The association of Work condition, Psychosocial Environment and Pharmacist dispensing error
摘要
目的:本研究之目的為調查目前台灣的藥師發生調劑錯誤及錯誤類型，與工作環境、組織社會心理狀態之相關性，並依據研究結果對醫院藥劑部門提出降低調劑錯誤的策略建議。 方法:本研究主要採用結構是問卷、付出回饋失衡模式(Effort-Reword Imbalance Model)之量表和ASHP(1993)提出的有關藥師調劑錯誤的類型作為測量工具，調查對象為92年地區教學醫院以上的藥師。本研究採次級資料分析，資料包含國內分布於各地區的59家醫院藥劑部門，共846份筆問卷資料。 結果:在填答藥師的自覺錯誤中，發生調劑錯誤類型的頻率最高的為「數量錯誤」，發生頻率第二的錯誤為「藥名錯誤」，發生頻率排名第三的錯誤為「漏拿藥品」，排名第四為「因為藥品外觀相似而拿錯」。 藥師填答付出回饋失衡量表結果，19.8%呈現「失衡狀態」，以得分三分法分組，30.6%表現「高付出且低回饋」；進行兩次的回歸分析結果，藥師調劑錯誤的發生，會受到付出回饋失衡狀態、工作年資、每月查詢藥學資訊次數和藥品擺放規則的影響。 建議：(1)建議主管應留意藥師知覺壓力表現 (2)本研究建議以字母及藥品代碼排列藥品的醫院改為依藥理分類擺放。(3)未來的研究者針對此一主題，可以嘗試將樣本擴大至地區醫院及診所藥師。
並列摘要
Objective : The purpose of this study is to understand the dispensing error type of hospital pharmacist and to explore the association of work condition, psychosocial environment and dispensing error , and to bring up some suggestions for hospital pharmacy department according to this study outcome. Methods: The Effort-Reward Imbalanced model is used to examine psychosocial environment among pharmacists in hospital. To detect dispensing error of a pharmacist, ASHP (1993) pharmacist error types were applied. This study was a secondary data analysis of cross-section questionnaire survey among 846 pharmacists in 2003. Results: The most frequent types of self-reported errors is as follows: first, “the wrong quantity given”, second, “the wrong drug was given”, third “not fill”, fourth “a look alike or similar drug was given”。 The results indicate that 30.6% pharmacists with high effort/low reward imbalance measured by ERI model and the dispensing errors were significantly associated with work seniority, average frequency of looking up pharmaceutical information, the rule of placing the drug and psychosocial environment with effort reward imbalance. Suggest: According to the above study, it would suggest: (1)the administrator should concern about the pharmacist with effort reward imbalance had elevated risks of poor performance.(2)the heads of pharmacy keep a closer tab on the younger less experienced pharmacists and be actively training these younger pharmacists to further their performance.. (3) Future researchers can add the standard questionnaire, and can consider expanding the object of study to local hospital and clinic pharmacist.