病室公藥管理改善方案

Improving the Management of Commonly Used Drugs in the Ward Situation

提供安全的給藥，是護理工作中重要的一環，本院採用單一劑量配藥，但仍有部份是公用製劑稱為公藥，十類公藥中除麻醉藥及急救藥三班清點外，其他公藥未設定公藥量，公藥櫃及冰箱中均發現過期藥品，專案小組查核統計公藥完整性僅為73.5%，其中未過期完整性62.5%，註明使用或領用日期71.3%，公藥無變質98.8%，合宜公藥量61.3%，總計公藥管理缺失事件124件，過期丟棄公藥成本為7427.1元。為提昇公藥管理完整性，降低醫療資源浪費及給藥過程中發生潛在性錯誤，提供護理人員安全給藥環境。專案小組於93年1月至94年4月改善時間，將公藥櫃藥品標示並依有效日期排列，宣導開封和領入藥劑須登記日期，設定合理公藥量，改善後公藥管理完整性提昇為98.3%，進步24.8%，其中公藥未過期項目，提昇為97.2%，註明使用或領用日期項目，提昇為98.9%，公藥無變質項目更達100%，制定合理公藥量項目提昇為97%，十類公藥中，完整性皆達到90%以上，並且公藥管理缺失事件降低為37件，公藥過期費用降為761.5元。

Prescribing medications with care plays an important role in nursing. We administer drugs in single doses, according to our hospital's regulations. However, there are still some commonly used medications that are kept on the ward. Among these commonly used medications, only analgesics and drugs for emergencies are counted every shift. The other drugs do not have a standard dose held in reserve and some expired drugs are often found in the ward’s refrigerator. Our study found that only 73.5% of commonly used medications were still viable: 62.5% of these drugs had not exceeded their expiry date; 71.3% were labeled with a use-by date; 98.8% were in good condition; 61.3% were stored in appropriate amounts. There were a total of 124 cases of inappropriate management of commonly used medications. The cost of the expired drugs was NT$ 7427.10. Promoting effective management of commonly used medications, avoiding waste of medical resources, avoiding errors in administering medications to patients and providing a safe medication-giving environment are very important topics at present. Therefore, we spent 14 months (from October 2003 to December 2004) labeling drugs correctly, arranging them according to expiry date, promoting registration of the date of use and setting an appropriate amount to be kept in reserve. After this, the percentage of viable drugs increased to 98.3% (an increase of 24.8%). Amongst these drugs, those that had not exceeded their expiry date increased to 97.2%, those that were well-labeled increased to 98.9%, and those in good condition reached 100%. Appropriate amounts of drugs kept in reserve increased to 97%. Ninety percent of these 10 commonly used medications now reached qualification. [Meaning of this phrase is unclear.] In addition, the incidence of inappropriate management of drugs dropped to 37%. The cost of expired drugs was reduced to NT$ 761.50.