運用智能化點滴拋轉系統提升化療給藥完整率之改善專案

本專案之目的為提升化療給藥安全，達成化療給藥完整率100%之目標。統計2013年1月1日至2015年12月31日期間，本單位發生15件化療給藥輸注速度錯誤之情形，異常事件發生率為0.018%（15件／84367人x100%），發生導因為醫囑資訊僅呈現化學藥物需滴注之時間，護理師需自行計算每小時應滴注之速率，且點滴控制器由護理師手動設定後，雙人進行檢核始可進行給藥。解決辦法為資訊系統再造，透過醫囑系統自動計算給藥流速，及使用點滴控制器上之RS232介面程式，使用轉接線將RS232所拋出的訊息加以分析管理，使得點滴控制器可拋轉人工設定的滴速與醫囑系統計算的滴速進行檢核，檢核無誤後，方可進行化療給藥。實施改善辦法後，化療給藥完整率查核結果為100%，達專案目標。

關鍵字

智能化；化療給藥；點滴控制器

並列摘要

The objective of this project is to improve the safety of drug administration so as to achieve the goal of zero deficiency during chemotherapy. According to the data taken from 1 January, 2013 to 31 December, 2015, a total of 15 cases out of 84367 patients, or 0.018%, were found to have error(s) on the infusion rate in the process of drug administration. Based on the finding in this project, the major cause of these errors was mainly due to the manual calculation of drug infusion rate by the nurse in charge, since only drug infusion time was indicated on the medical advice information. After manual setting of the infusion controller set up by the nurse in charge, verification of the setting was performed by another nurse before drug administration. Nonetheless, this process could hardly be tracked and verified by information system. In this project, information system reengineering was used as the solution. Through automatic calculation of infusion rate by the medical advice system and the installation of RS232 interface program on the infusion controller, the message from RS232 could be delivered and verified before drug administration. With the implementation of this method, deficiency of drug administration during chemotherapy was found to be zero. Hence, the goal of this project was achieved.

並列關鍵字

intelligent ； chemotherapy administration ； drop controller

參考文獻

Samaranyake, N. R., Cheung, S. T. D., Cheng, K., Lai, K., Chui, W. C. M., & Cheung, B. M. Y., (2014). Implementing a bar-code assisted medication administration system: Effect on the dispensing process and user perceptions. International Journal of Medical Informatics, 83(6), 450-458. doi:10.1016/j.ijmedinf.2014.03.001

翁悅芳、梁惠玉、林瓊玉（2013）。降低護理人員化療靜脈給藥之不完整率。澄清醫護管理雜誌，9（1），65-72。