南區某優等醫院之藥事作業自我評估研究分析

Evaluation Pharmacy Practice Quality of A Regional Teaching Hospital by the Best Practices Self-Assessment Tool

朱雅蘭(Ya-Lan Chu)

指導教授 ： 溫燕霞

高雄醫學大學/藥學院/藥學研究所碩士在職專班/碩士(2009年)

摘要

研究目的：
利用美國健康體制藥師協會（American society of health-system pharmacists，ASHP）於2004年公布「最佳藥事作業自我評估表」，進行優等教學醫院與醫學中心藥事作業自我評估，比較藥劑部門現今的作業流程，並探討兩者間的差異處，進而期望提出適合國內的藥事作業標準及評估方法之建議。
研究方法：
將最佳藥事作業自我評估表編譯成中文，內容有9大構面，共有127個細項。邀請五家優等教學醫院及十家醫學中心的藥劑部門參與最佳藥事作業自我評估，其結果以SPSS軟體進行統計分析。
研究結果：
優等教學醫院與醫學中心評估其作業執行狀況，有顯著差異的構面是「發展藥物使用政策」（p = 0.041），其中臨床試驗用藥的執行，優等教學醫院顯著低於醫學中心（p = 0.017）；其他8個構面則沒有顯著差異。
某優等教學醫院設有定期檢視及改善服務品質之規範，以條碼技術協助藥物辨識及運送，於「藥物調劑及運送」及「藥事服務提供之評估」2個構面，其執行情形顯著高於醫學中心（p值分別是0.030及0.019），其他7個構面則沒有顯著差異。
結論：
現今，依國內醫院評鑑分級制度所分的醫學中心與優等教學醫院，在最佳藥事作業自我評估之執行情形的差異不大。目前醫院評鑑基準在藥事作業方面項目不多，所以無法有效區分醫學中心與優等教學醫院的藥事作業執行情形。

關鍵字

藥事作業 ； 自我評估表 ； 國內醫院評鑑

並列摘要

Object:
The self-assessment of regional teaching hospitals and medical centers according to the Best Practices Self-Assessment tool which was published by ASHP in 2004 was performed. The aim of this study was designed to compare both pharmacy practices nowadays and investigate the differences between them, further more to suggest the proper pharmacy practice standard for domestic evaluation method.
Methods:
To compile “The Best Practices Self-Assessment tool” into Chinese, there are 9 sections and total 127 statements. The pharmacy departments of 5 regional teaching hospitals and 10 medical centers were invited to take part in the self-assessment of their pharmacy practices by the tool. The reaults were statisticaliy analyzed with the SPSS software.
Result:
A section of the self-assessment tool being significantly different between regional teaching hospitals and medical centers is “develop medication-use policy” (p=0.041). “The control and use of investigational drugs in clinical research” in the section of “develop medication-use policy”, regional teaching hospitals are obviously less than the medical centers（p = 0.017）. And the other 8 sections have no significant difference.
A regional teaching hospital had been to set the periodic inspection of pharmacy service and the regulation of procedure improvement, bar-coding technology used to assist the pharmacy identifying and delivering the medicines. Two sections: “dispense and deliver medications” and “evaluate the delivery of pharmacy services”, the self-assessment of the regional teaching hospital is better than medical centers (p=0.030 and p=0.019). And the other 7 sections have no significant difference.
Conclusions:
At present the pharmacy practice evaluated by the self-assessment tool between medical centers and regional teaching hospitals according to the domestic Hospital Accreditation, there are little differences. The items of the pharmacy practices in Hospital Accreditation now are too few to efficiently distinguish the pharmacy practices between medical centers and regional teaching hospitals.

並列關鍵字

pharmacy practice ； self-assessment tool ； domestic Hospital Accreditation

參考文獻

1.財團法人醫院評鑑暨醫療品質策進會，醫院評鑑工作簡介，http://www.tjcha.org.tw/Identify.asp?catid=2

2.American Society of Health-System Pharmacists Research and Education Foundation. http://www.ashpfoundation.org/default.aspx

3.ASHP Best Practices Self-Assessment Tool Instructions. American Society of Health-System Pharmacists; 2004. Available at: http://www.ashp.org/practicemanager/ResourcesforBestPracticesSAT.pdf

4.Steven P. Nelson, Paul W. Abramowitz. Using the ASHP Best Practices Self-Assessment Tool. Am J Health-Syst Pharm. 2004; 61: 562-3.

5.The role of the pharmacist in the health care system. Preparing the future pharmacist: Curricular development. Report of a third WHO Consultative Group on the role of the pharmacist, Vancouver, Canada, 27–29 August 1997. Geneva: World Health Organization; 1997.WHO/PHARM/97/599. Available at: http://www.who.int/medicinedocs