臨床用藥監測系統建置與效益分析之研究

System Development and Benefit Evaluation for Monitoring Clinical Medication for Monitoring Clinical Medication

王穎淑(wang ying shu)

指導教授 ： 蕭翰文

亞洲大學/資訊學院/生物資訊學系碩士班/碩士(2007年)

摘要

用藥安全是近年來國內外醫藥界關心且致力改善的議題。對於不適當的藥物劑量或間隔使用不僅會造成藥物不良反應，也可能引發無法預測而危急病人安全的事件。由於腎臟是身體許多藥物代謝排出的器官，國外許多專家學者為了提高腎功能不良病人的用藥安全，建置以血液肌酸酐清除率(CrCl)為評估基準的用藥安全監測資訊系統。相較國內在此領域的蹣跚步履，我們改良國外系統以醫師使用的電子處方輸入(Computer Physician Order Entry，CPOE)介面，改由電腦自動為藥師計算出CrCl值，並主動監測腎功能不良住院病人的用藥資訊系統，該系統主要功能： (1) 結合檢驗資訊系統，自動過濾腎功能不良病人;(2) 自動計算CrCl;(3) 由藥師自行設定各類腎排除及腎毒性的監測藥項，再依照病人不同CrCl的等級，警示病人用藥中對於監測品項的現況安全劑量及間隔方式該系統的建置，不僅提高病人用藥安全，也提高了藥師人力效能。此外，我們也藉此系統的建置，分析並討論國內外此項醫療資訊系統的落差可能性，並提供未來可改良模式。

關鍵字

臨床用藥

並列摘要

The domestic and international medicine feverously concerned the safety of using medicine and devoted to improve it in recent years. It will not merely causes adverse drug reactions to use inappropriate medicine dosage or interval and may cause the unpredictable and critical patient safe incident event. Kidney is the major organ for the medication excretion. To improve drug safety for patients with insufficient renal function, many worldwide experts set up the medication safety monitoring information system, which is based on the evaluation of CrCl concentration in blood. We improved the foreign system for the doctors to use the electronic prescription interface (Computer Physician Order Entry, CPOE) . The CrCl values can be calculated automatically by the computer system for the pharmacist. This system can voluntarily monitor the information of using medicine system for the patients with bad kidney function.
The main functions of system are as following: (1) Combine LIS, and filter the patient with renal insufficiency automatically;(2) Estimate the CrCl using data available electronically;(3) Pharmacist sets up the renally excreted or nephrotoxic medications which to be monitor this system by oneself, and then according to the patient different CrCl range, display a recommended dose or interval.The construction of this system not only improves the Safe Use of Medication for patients but also improves pharmacist's efficiency. In addition, we also analyze and discuss the gap between internal and international of similar monitoring medication information system, we hope to get better ways to develop in future.

並列關鍵字

Monitoring Clinical

參考文獻

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