建置藥品調劑檢核資訊系統輔助門急診調劑作業及成效評估

Developing and evaluating the effectiveness of a Dispensing and Inspection Information Technology System to support outpatient and emergency dispensing operations in a regional hospital

目的：為降低潛在的醫療疏失，醫療院所開始運用資訊科技系統輔助整個醫療過程的執行，期能預防疏失，降低成本，並提升服務效能及照護品質。本研究以藥品調劑檢核資訊系統建置的功能性、藥師使用滿意度以及系統投資的效益作為成效評估。方法：本研究乃呈現某區域教學醫院運用條碼及資訊科技系統，建置門急診藥品調劑檢核整合資訊系統及其成效的評估。此系統可與院內醫囑系統、病歷、藥歷、檢驗及批價系統連結，並提供易調劑錯誤藥品圖示警示、病人多科看診用藥評估、藥品交互作用提示及藥物跡近錯失事件通報等功能。結果：藥師整體滿意度從系統建置前的平均2.7±1.2 分，建置後提升至4.2±0.8分。系統投資回收年限為10 個月。另外，此系統提供了簡易藥物跡近錯失事件通報功能，大幅提升了通報率，門診藥品調劑跡近錯失通報率從建置前的0.02%，建置中上升至0.24%，並於改善方案介入後降至0.19%。結論：建置藥品調劑檢核資訊系統可有效提升門急診病人用藥安全並降低醫療作業成本。

Objectives: In order to reduce the potential for medication errors, prevent negligence, reduce costs and improve service effi ciency and quality of care, hospitals have begun to implement information technology systems. Methods: A regional teaching hospital used bar codes and information technology to build a drug dispensing and inspecting system to assist pharmacy practice in outpatient and emergency units and to evaluate the effectiveness of the system. This system can be linked to CPOE, medical history, laboratory and payment systems, and provides dispensing error-prone medicine icon alerts, multidisciplinary visit assessments, drugdrug interaction alerts and recordings of near-miss medical events. We assessed the effectiveness of the system according to functionality, pharmacist satisfaction and costeffectiveness. Results: Pharmacist overall satisfaction scores averaged 2.7±1.2 before and 4.2±0.8 after the system was introduced. The system payback period was ten months. Because the system provided a simple reporting function for near-miss medical events, the reporting rate increased dramatically from 0.02 percent before set up to 0.24 percent after implementation. Data fell to 0.19 percent after implementing the improvement plan. Conclusion: This system effectively enhanced medication safety and reduced health care operation costs.