降低高齡病房口服藥物異常領用率

Reducing the Rate of Abnormal Oral Drug Utilization in Elderly Patient Wards

張嘉珣(Chia-Hsun Chang) ； 朱莉螢(Li-Ying Ju) ； 王偉靜(Wei-Jing Wang) ； 洪欣棠(Xin-Tang Hong) ； 彭雅微(Ya-Wei Peng) ； 李椗蓉(Ting- Jung Li) ； 張靜雯(Ching-Wein Chang)

《榮總護理》 37卷3期 (2020/09) Pp. 260-267

https://doi.org/10.6142/VGHN.202009_37(3).0005

摘要

台灣高齡長者常同時罹患多種慢性病，造成口服藥物品項多，而住院中執行給藥的任何一個環節疏失，將面臨重新領藥，導致延遲給藥，嚴重甚至會影響到高齡長者生命安全。本單位2016年及2017年連續兩年藥物異常領用率高達0.10%及0.12%，引發本組改善動機，故本專案目的為降低高齡病房口服藥物異常領用率。經分析發現主要因素包括：護理人員藥物剩餘量未留、護理人員藥物遺失、護理人員藥物散落、高齡長者及家屬藥物掉地、設備及流程。透過重新規劃藥櫃空間，藉由視覺警示提醒及稽核制度，強化護理人員在職教育，創新輔助藥盒等解決策略以落實給藥安全，專案實施後異常領用率降至0.05%，達專案目標。透過專案期能降低高齡病房異常領用率及防範人為疏失發生，提升高齡長者用藥安全，促進照護品質。

關鍵字

口服藥物異常領用 ； 高齡病房 ； 用藥安全

並列摘要

Older people in Taiwan are often affected by multiple chronic diseases, which increase their utilization of different types of oral medicine. Inadequate administration of drugs to older patients during hospitalization strongly affects their survival. In our apartment, the rate of abnormal drug utilization in 2016 and 2017 ranged between 0.10% and 0.12%, which triggered our motivation for improvement. The purpose of this study was to reduce the rate of abnormal utilization of oral drugs on elderly patients' wards. Our analysis suggested that abnormal drug utilization was mainly caused by human factors, including the nursing staff, older patients, and their families. Through replanning of the medicine cabinet, establishment of a visual warning reminder and audit system, strengthening of on-the-job education of nursing staff, and innovation of auxiliary drug kits and other solutions, the abnormal utilization rate was reduced to 0.05%. Overall, the project goal was achieved, which suggests that the developed strategies can be used to prevent errors due to human negligence, improve the safety of medication use in older patients, and increase the quality of care.

並列關鍵字

abnormal use of oral drugs ； elderly wards ； medication safety

參考文獻

楊書姍(2011)‧高齡族群藥盒使用性探討(未發表的碩士論文)‧台北：國立台北科技大學。

阮祺文(2012)‧改善注射藥物包裝標示促進注射用藥安全，醫療品質雜誌，6(5)，113-119。

楊曉菁、呂欣茹、陳怡靜(2005)‧給藥疏失之護理觀‧慈濟醫學雜誌，17 (4)，41−46。

Advinha, A. M., Lopes, M. J., & de Oliveira-Martins, S. (2017). Assessment of the elderly's functional ability to manage their medication: A systematic literature review. International Journal of Clinical Pharmacy, 39(1), 1-15.

Elliott, R. A., Goeman, D., Beanland, C., & Koch, S. (2015). Ability of older people with dementia or cognitive impairment to manage medicine regimens: A narrative review. Current Clinical Pharmacology, 10(3), 213-221.