藥品警訊系統及處方評估訓練應用於新進藥

Drug Alerts System and Prescription Evaluation Training for New Pharmacists

本研究針對成大醫院藥劑部領證兩年內新進藥師，收集於96年1月至98年4月期間，利用「藥品作用與警訊限制」和「藥品交互作用警示系統」及處方評估訓練，評估領證兩年內新進藥師審核所有門、急診及住院病患處方之合理性能力。期間共陸續有16位領證兩年內新進藥師參與訓練，共收集7,317筆疑義處方，其中領證兩年內新進藥師佔1,134筆。研究結果發現，經訓練後領證兩年內新進藥師每人每月平均發現疑義處方之筆數由96年平均1.65筆，增加至97年的3.47筆及98年7.39 筆；相較於全院藥師之平均筆數，有明顯提升（50.77％ vs 96.57％ vs 136.28％）。結論建議，領證兩年內新進藥師由於較無臨床經驗，對處方判讀的能力不足，所以若只藉由累積工作經驗及逐步的學習方式，往往須等待長時間才能獨當一面；利用本訓練方式顯示可顯著增加領證兩年內新進藥師對處方的判讀能力，增進藥師人員的專業能力。

This study was to assess the ability of prescription evaluation of new pharmacists licensed within two years in the Department of Pharmacy in National Cheng Kung University Hospital (NCKUH). Prescription data between January 2007 to April 2009 were analyzed, and we use the 'Computerized Drug Alert System', 'Drug-Drug Interaction Warning System,' and prescription evaluation training to assay the competence in assessing the appropriateness of prescriptions in emergency, outpatient, and inpatient pharmacy. A total of 16 new pharmacists licensed within two years were involved in the training. We totally collected 7,317 inappropriate prescriptions, in which 1,134 were accounted by new pharmacists licensed within two years. The results found that the monthly average of inappropriate prescriptions was 1.65 per pharmacist in 2007, increased to 3.47 in 2008 and 7.39 in 2009; compared to all pharmacists (including new and senior pharmacists in NCKUH), which was significantly increased (50.77% vs 96.57% vs 136.28%). In conclusion, due to lack of professional experience and ability to evaluate prescription appropriateness in new pharmacists licensed within two years, this training method significantly enhanced their ability and professional competence in a shorter period rather than learning through working experience alone.