南台灣某教學醫院護理人員之靜脈藥物計算能力探討

The Intravenous Medication Calculation Abilities in Registered Nurses at a Teaching Hospital in Southern Taiwan

給藥錯誤會使病患延長住院或導致死亡，特別是靜脈藥物。劑量不足、計算錯誤是靜脈藥物錯誤主因。國外有許多專家投入醫事人員藥物計算能力研究，國內仍缺乏。本研究目的：一、確認護理人員之靜脈藥物計算得分。二、找出護理人員靜脈藥物計算得分的影響因素。研究採方便取樣，選擇南部某區域教學醫院之護理人員和護生為對象，在取得機構IRB同意後，以自擬試卷（16題填充）作為測量工具，工具經內容效度(CVI=80%~100%)與一致性信度(α=.808)，共收得185名護理人員和70名護生資料，以SPSS Windows 13.0 統計軟體進行描述性統計、Chi-Square、Spearman correlation、Mann-Whitney U test、Kruskal-Wallis test分析，結果：一、護理人員藥物計算平均為11.77±3.20分。二、護生藥物計算平均為3.90±2.94分。三、護理人員藥物計算得分比護生高(p=.000)。四、影響護理人員藥物計算得分的因素有年資和進階職級。本研究能提供醫院管理者和學校老師在持續性品質促進與人員教育安排之參考。

Medication errors, especially related to intravenous medications, can lead to the prolonged hospitalization and even patient death. Subtherapeutic dose and dose calculation errors represent the major cause of intravenous medication errors in hospitals. Many investigators have undertaken studies to evaluate the dose calculation ability of healthcare professionals. However, little is known about the dose calculation ability for intravenous medication among nurse staff and nursing students in Taiwan. Goals of this study were to evaluate the intravenous medication calculation ability of registered nurses and nursing students and determine the relationship between dose calculation ability and various nurse demographic characteristics. The study was approved by the institutional research ethics committee. A convenience sample of 185 nurse staff and 70 nursing students were recruited from a teaching hospital in southern Taiwan. A self-developed questionnaire containing demographic information and a sixteen item dose calculation examination (CVI=80%~100%, test-retest reliability α=.808) were used. Descriptive Statistics, Chi-Square test, Spearman correlation, Mann-Whitney U test, and Kruskal-Wallis test were analyzed using SPSS Windows 13.0. Findings showed an overall mean score of dose calculation ability for intravenous medication of 11.77±3.20 among nurses and 3.90±2.94 among nursing students. The dose calculation ability of nurses was higher than that of nursing students, and the dose calculation ability of the nurses was positively associated with working years and clinical ladders. Findings are discussed in terms of implications of continuous quality improvement as well as continue education for hospital managers and nursing educators.