應用條碼科技改善給藥及採檢安全之成效

Effect of Barcode Technology on Improving Medication Administration Safety and Specimen Collection

目的：近年來醫療不良事件為病人安全重視的課題，面對重視效能及服務品質的照護環境，僅藉由建立作業標準、監測等措施，已無法防堵相關異常事件，故專案目的為藉由導入條碼科技之輔助作為安全屏障，以減少病人辨識、給藥及採檢錯誤之發生。材料與方法：2013年9月成立資訊條碼系統推動小組，由副院長擔任召集人，品質中心擔任推動單位，成員包含跨科部之主管，規劃與督導全院條碼系統上線順序及進度、解決系統性問題、提供相關資源等，並由護理部、藥劑部、病理部及資訊室組成藥物及採檢條碼工作小組，進行系統開發及執行規劃進度。結果：住院病人藥物異常事件發生率自2013年0.0023%下降至2017年1-6月0.0014%、檢驗異常事件發生率自2013年0.0012%降至2017年1-6月0.0003%、病理組織異常事件發生率自2015年0.0343%降至0.0171%，且血液類檢體退件率自2013年0.182%降至2017年1-6月0.036%。結論：運用條碼資訊進行臨床業務改善，確實能降低藥物及檢驗相關異常事件發生率，並能有效減少檢體退件率，增加檢驗時效及報告效能。 Objective: Adverse medical events represent a major patient safety concern. In a healthcare environment that focuses on performance and quality, such medical events cannot be prevented by establishing standards and monitoring alone. The aim of this study was to apply a barcode informatics system to reduce errors in patient identification, medication administration, and specimen collection. Methods: A barcode system project team was established in September 2013. The vice president served as facilitator, and the quality center as the promotion unit. The core members werethe heads of transdisciplinary departments, who planned the bar code system’s online priorities, resolved systemic problems, and supplied related resources. Staff from the departments of nursing, pathology, and information composed a barcode focus group whose task was to implement the planning process. Results: After implementing a laboratory barcode informatics system, the rates of medication errors in 2013, 2014, 2015, 2016, and 2017(first half-year) were 0.0023%, 0.0015%, 0.0018%, 0.0023%,and 0.0014%, and the rates of laboratory errors were 0.0012%, 0.0010%, 0.0016%, 0.0007%, and 0.0003%, respectively. Moreover, the specimen rejection rate decreased from 0.182% to 0.036% between2013 and 2017. Conclusion: Using barcode technology to improve medication administration and clinical laboratory practice can reduce the incidence of errors in patient identification, medicationadministration,and sampling, as well as effectively decrease the specimenrejection rate and increase laboratory efficiency and reporting performance.