運用無線射頻辨識技術建立管制藥品安全系統

Building a Secure RFID Enabled Application for High Risk Drugs Control and Management to Enhance Patient Safety

詹皇謙(Huang-chang Chan)

指導教授 ： 劉立

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2006年)

摘要

近年來病患安全的議題受到世界各國的重視，根據醫院評鑑暨醫療品質策進會於2003年八月間，針對醫院內工作人員的問卷調查結果顯示，受訪者經驗中醫療不良事件的類型，佔最多數的事件為藥物錯誤，包括口服或針劑藥物的劑量錯誤或給錯藥或給錯病人等，佔了總數的23％。然而醫療上所造成的「疏失」或「錯誤」，尤其管制藥品因其本身所具之特性，所以在管理及使用上，倘若發生疏失或者錯誤，後果都將會非常嚴重直接關係到人的生命及健康。因此如何設法降低用藥錯誤發生的機會，是一個值得研究的課題。 本研究利用RFID在進行識別工作時不需人工介入的特性，建立一個RFID管制藥品安全系統，透過電腦語音及圖像的雙重提示，經由RFID具有的自動性、無方向性、以及高度可辨識性等特性，協助醫護人員取藥時『三讀五對』的確認，並改善了傳統『三讀五對』用藥流程中所可能發生的人為疏失，並可加強管制藥物的管理，阻斷錯誤的發生，提升用藥安全。

關鍵字

病人安全 ； 用藥安全 ； 管制藥品 ； RFID

並列摘要

In recent years, most of the countries in the world have paid the closest possible attention and raised awareness and commitment to improve the quality of patient safety. In August 2003, TJCHA (Taiwan Joint Commission on Hospital Accreditation) has enquired hospital personnel about adverse event and medical errors by questionnaires, the result showed that highest rate among different adverse events is medication errors including giving wrong doses、wrong patients and wrong drugs, the false rate reached 23% of all. As often as not the medication errors caused deaths and injuries especially for controlled drugs, such incidents remind us how important the improvement must be carefully and continuously proceeded to reduce the possibility of medication errors. In this study, we use RFID technology that doesn’t require the line of sight touch to build up the Controlled Drugs System for medication safety. Accompanying with the assistance of voice and image, this system applies the RFID’s characteristics of automatic identification and the RFID reader scans and acknowledges freely the information from RFID tags when they are within range of an electromagnetic field to refine the traditional checking process of “Five Rights and Three Checks safeguards” for medical personnel. Also, system can enhance the managements of high-risk drugs in hospital to reduce the possible human errors and improve medication safety.

並列關鍵字

Patient Safety ； Medication Safety ； Controlled Drugs ； RFID

參考文獻

Graham Neale, FRCP, Maria Woloshynowych, PhD, and Charles Vincent, PhD. Exploring the causes of adverse events in NHS hospital practice. J R Soc Med. 2001 July; 94(7): 322-330.

T. S. Lesar, L. Briceland and D. S. Stein. Factors related to errors in medication prescribing. JAMA,1997;277(4), 312-317。

石崇良，認識病人安全，財團法人醫院評鑑暨醫療品質策進會. available at http://www.tjcha.org.tw/safe/safe01.asp accessed Mar 15, 2004 行政院衛生署管制藥品管理局. available at http://www.nbcd.gov.tw/aud/aud_1-04.asp accessed Sep, 2002. 國家衛生研究院. available at http://www.nhri.org.tw/nhri_org/pr/newspage/23331128_1.htm accessed Nov 28,2003. 國家衛生研究院公共事務組新聞. available at http://www.nhri.org.tw/nhri_org/pr/newspage/20031128_1.htm accessed Nov 28, 2003. 陳秀梅博士，RFID 國際標準簡介及台灣之對策. available at http://www.can.org.tw/2004-03_6.htm，p13-p20 accessed 2004. 曾慧萍摘譯，2004年JCAHO 病人安全目標. available at http://ttw3.mmh.org.tw/qcc/download/safe.htm accessed 2004.

中文文獻

刁建成，《RFID原理與應用》，台北，全華科技圖書股份有限公司，民94.3。 行政院衛生署管制藥品管理局，《管制藥品管理條例》民94.1。