從醫師處方中建置即時用藥安全機制

Implementation of Drug Safety in Prescribing

王奇威(WANG CHI WEI)

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

It is estimated that over three-quarters of a million people are injured or have died in hospitals each year caused by adverse drug events. The majority of medical errors result mainly from poorly designed health care systems rather than from negligence of health care providers.
While there are considerable evidences that information technology can be used significantly to reduce medication errors and adverse events, information technology, to be effective, must be implemented by using a system approach.
Medication errors and preventable adverse drug events are so common that about half of the medication errors occur during medication ordering. For physicians, prescribing of drugs is one of the most common daily practices. Doctors have considered alert messages very valuable during drugs prescribing for error-preventive health information.
The most common frustrations for prescribing are : (1) not having the instant and real time alert messages, (2) not having patient-oriented interface to maintain health information , and (3) not having the flexibility to customize the alert message.
High-quality Outpatient Prescribing System has to be emphasized to reduce the prescribing problems that are caused by omission of alert messages. The evidence for error reduction with Outpatient Prescribing System is based on the actual practices of patients applied to the "homegrown" systems, and is not from the commercial products available in the market.

關鍵字

用藥安全 ； 門診處方系統 ； HASH(0xb35ec0c)

並列摘要

It is estimated that over three-quarters of a million people are injured or have died in hospitals each year caused by adverse drug events. The majority of medical errors result mainly from poorly designed health care systems rather than from negligence of health care providers.
While there are considerable evidences that information technology can be used significantly to reduce medication errors and adverse events, information technology, to be effective, must be implemented by using a system approach.
Medication errors and preventable adverse drug events are so common that about half of the medication errors occur during medication ordering. For physicians, prescribing of drugs is one of the most common daily practices. Doctors have considered alert messages very valuable during drugs prescribing for error-preventive health information.
The most common frustrations for prescribing are : (1) not having the instant and real time alert messages, (2) not having patient-oriented interface to maintain health information , and (3) not having the flexibility to customize the alert message.
High-quality Outpatient Prescribing System has to be emphasized to reduce the prescribing problems that are caused by omission of alert messages. The evidence for error reduction with Outpatient Prescribing System is based on the actual practices of patients applied to the "homegrown" systems, and is not from the commercial products available in the market.

並列關鍵字

Drug safety ； Prescribing System

參考文獻

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[4] Raschke,Robert A.MD, MS; Gollihare,Bea MS,RN; Wunderlich, Thomas A.RPH et al. A Computer Alert System to Prevent Injury From Adverse Drug Events: Development and Evaluation in a Community Teaching Hospital. JAMA, Volume 280(15).Oct.21,1998.1317~1320.

[6] Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug event and potential adverse drug events. Implications for prevention. JAMA. 1995;274:29~34.

[7] Leape, Lucian L.;Bates, David W.;Cullen, David J.;Cooper, Jeffrey et al. Systems Analysis of Adverse Drug Events. JAMA, Volume 274(1).Jul 5, 1995.35~43.

[9] Chin TL.Using automation to reduce medication errors. Health Data Management. 1997 Jul. 5(7):74, 76, 78-83.