臨時給藥醫囑執行效率之改善方案

Project to Improve the Efficiency of Stat Order Process

給藥時間延遲是用藥安全規範中的一項缺失，而病患用藥安全已經成為醫療品質管理重點項目之一，鑑於目前有限之人力、工作量的增加，常使護理人員出現臨時給藥醫囑時間延遲的問題，經由統計發現三十分鐘內臨時醫囑給藥達成率只有27%。基於維護病患用藥安全，於2005年9月成立專案小組，其目的為提高臨時給藥醫囑之達成率，改善及緩解病患不適，分析延遲原因有「行動護理站電腦系統無警示、查詢及簽收功能」、「未告知勤務人員領藥時效性」、「急用藥盒擺放處狹小」、「執行步驟未標準化」、「工作相關設備適用性不佳」等因素。此專案藉由制定『臨時給藥醫囑作業流程』、『增加行動護理站電腦系統功能』、『定期舉辦在職教育』、『改善工作環境』、『不定時稽核』等改善措施下，使得三十分鐘內臨時給藥醫囑達成率由改善前27%提升至改善後91%，確實縮短臨時醫囑執行時間，使得病患的立即性問題在最短時間內，給予適當之處理達到緩解及治療不過情況。

The delay in delivering medicine to patients is one of the main problems in the issue of safemedication. Our statistical result indicated only 27% of stat orders were accomplished within 30minutes. So we constituted a project squad for the purposes to improve the accomplishment rate ofstat orders, and to relieve patients' illness and discomfort. By 'setting up protocol of stat order','enhancing function of computers of nursing stations', 'periodical medical education', 'improvingworking environment', 'unexpected scrutiny', the 30-minute accomplishment rate of stat orderswas improved promoted from 27% to 91%. We did shorten the temporal interval between thecomplaints of patients and the accomplishment of the stat orders. Finally, patients'problems can beresolved in a shorter period of time.