提昇急診護理人員口服給藥作業正確性

Improvement on the Correctness of Oral Medication Dispending Process by Staff Nurses in the Emergency Department

本專案目的在提升急診護理人員口服給藥作業正確性，以提升急診病人口服用藥之安全。由現況調查得知因急診病人就醫作業流程比照門診方式，口服用藥係交由病人自行服用，因此病人依醫囑正確服藥者僅達75.0%。經自擬之問卷及觀察表得知，護理人員執行口服給藥行為正確性平均為69.1%，提供病人用藥指導執行率76.0%，而病人對於口服給藥作業滿意度為77.8%。藉由制訂急診單一劑量給藥作業和標準流程、舉辦病人用藥安全在職教育課程、定期稽核護理人員口服給藥正確性，跨部門與急診醫學科、資管部、藥劑部溝通制定急診單一劑量給藥作業標準流程，並連結急診護理作業系統資訊功能等措施，改善後病人依醫囑口服給藥正確性由75.0%提升為100%，護理人員執行口服給藥行為正確性由69.1%提升為100%；病人對於護理人員執行口服給藥滿意度由77.8%提升至98.4%，明顯提升病人用藥安全，也提升了病人及家屬對於護理人員執行口服給藥之滿意度。

This project aimed to facilitate emergency department (ED) patient safety through affirming correct oral medication dispensing by the staff nurses. ED patients used to self-medication the same as the outpatient setting. However, only 75% of cases took oral medications correctly as per instruction. Surveys indicated that staff nurses correctly dispensed oral medications in only 69.1% of the cases, and offered correct guidance on drug administration in only 76%. Only 77.8% of patients were satisfied with the oral medication dispensing process offered by the staff nurses. Several measures were undertaken to affirm correct dispensing of oral medications, including the establishment of a unit-dose drug distribution system and standard medication-dispensing protocol, new training programs for staff nurses, and the incorporation of information system for the monitoring of the process. Consequently, not only all (100%) patients were found to correctly take oral medication as per instruction, but also all (100%) staff nurses became able to dispense oral medications in a correct fashion. Patients’ satisfaction with the oral medication dispensing process offered by the staff nurses has risen to 98.4% and patient safety has thus been greatly improved.