提升資訊化條碼系統給藥執行率專案

A Program to Improve the Implementation Rate for the Barcode Medication Administration System

背景：護理資訊運用條碼科技自動進行病人及處方藥品辨識，以提高給藥安全。本院自2014年5月開始推動條碼系統給藥，護理師執行率低僅32%，主要問題有1.手圈條碼模糊及破損；2.透明藥袋及輸液袋條碼不易掃瞄；3.使用條碼機掃瞄技巧不純熟；4.網路收訊不佳影響掃瞄；5.夜間掃瞄聲大打擾病人。目的：提升條碼系統給藥執行率從32%提升至80%。解決方案：本專案成員有護理師、電腦技術師及藥師，執行改善計畫：1.定期檢視手圈並適時更新；2.透明藥袋及輸液條碼處反白；3.示範條碼機掃瞄技巧及條碼機功能檢測；4.增設無線網路訊號接收點；5.公告條碼機音量調整步驟；6.制定獎勵制度等策略。結果：提升條碼系統給藥執行率從32%提升至85.2%。結論：本專案執行之措施，確實能提升護理師使用條碼系統給藥之意願，大幅提升執行率，達到此次之目標。

Background & Problem: Fully implementing the barcode medication administration system has been shown to help improve medication safety. We have promoted the barcode medication administration system in our hospital since May of 2014. However, the rate of implementation reached only 32% initially. We identified the major obstacles to fully implementing the barcode system as: (1) the barcodes on patients' wristbands were smudged or broken; (2) the barcodes on transparent drug bags and infusion bags were difficult to scan; (3) nurses were not familiar with the scanner and lacked the skills necessary to conduct barcode scans; (4) poor wireless Internet access inhibited effective barcode scanning; and (5) the beep sound generated during barcode scanning disturbed patients' sleep. The present project was conducted to improve the implementation by nursing staff of the barcode medication administration system. Purpose: The purpose was to increase the rate of implementation from 32% to 80%. Resolusions: The key members of the project were nurses, computer technicians, and pharmacists. The following procedures were conducted: (1) check the integrity of the wrist band and renew this band periodically; (2) print the barcode against a white background on transparent drug transfusion bags; (3) demonstration the skills of barcode scanning to nurses and inspect the function of scanners periodically; (4) increase the number of access points for the wireless network; (5) demonstrate the procedure for adjusting the sound volume on the scanner; and (6) provide rewards/incentives for using the barcode medication administration system. Results: The rate of implementation of the barcode medication administration system increased from 32% to 85.2%. Conclusion: This project significantly increased the use of the barcode medication administration system by our nursing staff. The procedures used in this project may be referenced by administrators at other hospitals with low rates of barcode medication administration system usage.