用藥安全輔助系統開發與建置之研究

Design and Implementaion of the Safety System for Medicine Prescription

謝明隆(Hsieh Ming Lung)

指導教授 ： 曹世昌

亞洲大學/資訊學院/資訊工程學系碩士班/碩士(2006年)

摘要

民眾至醫療院所住院時，一般是由護理人員負責進行給藥的動作，由於傳播媒體的發達，近年來陸續報導有醫療人員打錯針、給錯藥的事件，且報導出來的事件僅是冰山一角，因此如何防止用藥疏失的事件再度發生是刻不容緩的課題。
發生用藥疏失的幾個徵結點在於：辨識患者錯誤；忘給藥或非正確時間點給藥；患者治療曲線改變，無法即時回應給護理人員。原本護理人員於給患者投藥之前，僅做三讀五對的動作後即進行給藥作業，但以國內醫療環境而言，一名護理人員需同時照顧數名患者，因此發展更方便、更有效率及更正確的辨識與核對給藥內容的系統，來輔助護理人員給患者投藥前檢查，降低給藥疏失的發生率，不僅讓護理人員更放心投藥，也讓患者更安心吃藥，更可提昇醫療院所成為以病患為中心的醫院。
在本論文中我們採用條碼技術，首先於患者住院時即印出有條碼之手環，作為投藥前的患者身份確認；在藥局包藥時，印出內含條碼之標籤上，貼於每袋藥包上，並將此藥包上面的資料存放於資料庫；在護理人員投藥前以員工識別證上面的條碼進入用藥安全輔助系統，先掃描患者手環上的條碼來辦識患者，在選擇給藥時間點後掃描藥包上面的條碼，於系統中進行比對動作，若比對有誤電腦傳送錯誤訊息可能原因有：劑量錯誤、藥品錯誤、藥品管制時間錯誤、病患的曲線圖已經更新，規定的藥物治療已經改變等…；讓醫療護理人員可以更有效率的核對病患是否在〔正確的時間〕拿到〔正確劑量〕與標示了〔正確給藥途徑〕的〔正確藥品〕。

關鍵字

用藥安全 ； 輔助系統 ； 條碼

並列摘要

In the hospital, nursing staffs are supposed to be in charge of distributing medicines to the patients. However, due to the rapid development of the media interests, in the hospital recently, injection mistakes and incorrect medicines distribution cases are continuously reported to public. Those cases reported by the media are just the tip of the iceberg. How to avoid this kind of negligence-happening frequency is the most urgent issue to us right now.
Incorrect medicine distributions mostly occur in the following situations:
1. Mistake of patient identification.
2. Forget to give the medicine to the patient or give at the wrong time.
3. Patient’s healing curve doesn’t react to nursing staffs immediately.
In the past, nursing staffs distributing medicines to the patient only do few steps of double checking before taking the action. However, due to the medical environment in Taiwan, one nurse has to take care of several patients at the same time. Therefore, It is very urgent to develop a more convenient, efficient and accurate medicine distribution system to identify patients and check the medicines before giving medicines to the patient. By using the medicine distribution system to assist nursing staffs and double-checking before giving medicines, the chance of mistake will be reduced. Not just only it can help nursing staffs distribute medicines correctly, but also the patients can have no worry about the medicines. At the end, patient will become to the core of relationship of patient and hospital.
In theory, we are to use barcode technology. At the beginning, the patient registers at reception in the hospital and will be tied with a barcode bracelet on their wrist. It is in order to identify the patient before giving the medicines. In the pharmacy of the hospital, pharmacist will label patient’s barcode on the medicine bag and save the information at the hospital patient’s database.
When distributing the medicines, staff will be requested to verify through the staff ID barcode before entering the medical system. The patient’s barcode will be scanned in order to identify, they then select the patient’s medicine schedule and scan the barcode labeled on the medicine bag. Medical system will automatically check the process if it is correct. If not, it will display the message: “incorrect dosage”, “incorrect medicine”, “incorrect medicine distribution”, “patient healing curve has been updated”, “cure medicine has been changed”...and so on. Through the “save medicine distribution system”, it will assist nursing staff to be more efficient if patients have the [accurate dosage] medicine at [accurate time] and the labeling of the [accurate medicine] of [accurate distribution medicine procedure].

並列關鍵字

safety using medicine ； assistance system ； barcode

參考文獻

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