內科病房違反給藥磨粉禁現況之初步調查研究

A Preliminary Survey of Incompatibility of Pulverized Medications in Medical Wards

近年來，隨著醫藥科技的快速發展，新藥不斷的被發明，藥物的劑型出現各種不同的種類，這些不同的劑型種類並非階可磨粉使用。在國內一般的醫療情境中，醫師、藥劑師與護理人員均參與了給藥的工作，而護理人員大多數為給藥的最終執行者，其所負擔責任相當重要。目前臨床上，大多數醫護人員對藥物能不能被磨粉似乎無一具體完整的概念，甚至根本沒有想過此問題。本研究採調查法，以自行設計的調查評估工具進行實際訪談與資料收集，針對某醫學中心內科病房「給藥記錄違反磨藥禁忌」情況，及「醫護人員對磨粉禁忌藥物認知」兩部份做調查，結果發現違反顫粉禁忌比例高達67.9%，在違反磨粉禁忌之劑型上以持續緩釋錠和腸溶錠居多；醫護人員對磨粉忌藥物的認知方面，有半數以上（佔62%）護理人員不知道藥物能不能被磨粉，醫師方面也有75%的人不知道，對知道藥物不宜磨粉者，其訊息來源，護理人員大部份來自口耳相傳，醫師的訊息來源，則多來自護理人員，故醫護人員對於藥物劑型相關知識有普遍不足的現象。

Recently, with the advance of medical technology, new drugs and new dosage forms are being discovered at a fast pace. However, not all of these dosage forms can be pulverized or be used in their powder forms. In clinical situations, most health professionals have little knowledge of whether a drug can be pulverized and used as powder without adverse effects. Some of them have never thought that it may be a problem worth considering. In this primitive survey research, an evaluation sheet was developed which was used to record the noncompliance with in compatibility information on pulverized medications. An open-ended questionnaire was also designed to investigate knowledge related to compatibility to drug pulverization. The results showed over 67% incidence of incompliance events, most of them in sustained-release and enteric-coating forms. Over 62% of health professionals did not know whether a drug could be pulverized while 75% of medical doctors did not know. Most of their knowledge of this aspect is from information among nursing professionals. Moreover, even medical doctors received related information from nursing staff. Consequently, we discovered a general misinformation regarding dosage forms. The results of this study may be valuable for future design of medication education both in school and in-service for health professionals.