如何運用電腦支援系統,協助醫院用藥安全防護網的建立,是當前世界的趨勢。醫療疏失常與藥物使用過量及藥品的選擇不合適有相關,使用電腦支援系統可以迅速確實地發現並分析藥物使用的相關問題,輔助解決選擇藥品、劑量、頻率、使用天數、配伍禁忌等問題,例如利用電腦資訊建構藥物不良反應篩選與通報作業、抗生素的合理使用原則、藥品與檢驗值的連結、藥物過敏警示系統、藥物交互作用、重複用藥、每日最大劑量警示、給藥日數與重複檢核、懷孕用藥分級檢核、藥品使用原則等。架構此支援系統需要很多資訊整理連結等,才能達成目標,如藥歷檔需要與檢驗值密切連結,尤其是肝與腎功能,檢驗與藥品的基本檔良好連結,可以減少醫療疏失。另外,藥物過敏警示系統是必要的,而且是發展病人用藥安全系統最重要的一環。對於醫療疏失與病人用藥安全的關注,需要持續的軟體及硬體的改革與突破。電腦支援系統的建設,實為醫療改革的重要關鍵,將為病人安全加上多一層的保障。
Utilizing computerized decision supporting system to establish the protection network of medication safety is the worldwide trend nowadays. The occurrences of medication errors were commonly associated with overdosing and inappropriate choosing medications. The computerized system can detect, solve and analyze the problems related to medication use, such as suggesting drug of choice, dose, frequency, duration of use, and contraindication. These problems can be screened automatically by computerized checking and reporting programs with adverse reaction event, antibiotic selection, drug-laboratory interaction, drug-drug interaction, drug allergy checking, duplicating prescribing, maximum daily dosing, and pregnancy categories. Successfully establishment of the computerized system requires through consideration to link the database for pharmacists to accomplish the goal of drug safety. The fundamental infrastructure is to link databases of medication use and laboratory values to enable the calculation of renal or hepatic dosing adjustment. The function of computerized drug allergy program is not only documenting the patient's history, but also performing checking to avoid the cross-sensitivity. Continuous effort to improve the hardware and software of medication use is the key to protect medication safety for patients.
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