給藥錯誤－－護理人員之角色與責任

Medication Error--The Role and Responsibility of Nurses

給藥錯誤為臨床常見的醫療疏失，本文經由文獻查證發現給藥錯誤最常發生的錯誤型態是給錯劑量及給錯藥物，最常給錯的藥物是抗生素，而造成病人嚴重傷害的則是高危險藥物的給藥錯誤。導致護理人員的給藥錯誤原因有許多，可歸納為系統因素及個人因素，在系統因素上包括有儀器設備、人力及給藥流程等，而個人因素則包括個人藥物知識程度、計算能力及對政策的遵從性等，在這些因素當中，又以對藥物的知識不足是導致護理人員給藥錯誤的主要原因之一，其中包括了學校教育及在職教育之不足，綜合文獻查證，本文希望能夠提供給護理人員及護理教育作為參考。

Medication error is a common clinical mistake in medical treatment. Through review of related literature, this study found that the most common types of medication errors are inaccurate dosage and administration of wrong type of medication. The most common mistakenly administered medication is antibiotics, and medication error that involves high-risk drugs can cause potentially serious damage to patients. Many factors lead to medication error on the part of nurses. These factors can be differentiated as system factors and individual factors. System factors include equipment, human resources, and processes of administering or prescribing medication. Individual factors include extent of knowledge about medication, calculation ability, and adherence to policy. Among these factors, inadequate knowledge of medication is the main cause of medication error among nurses. The reasons behind inadequate knowledge include insufficiencies in both formal nursing education and on the job training. This study conducted a comprehensive literature review to provide references for nurses and nursing education.