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我院门诊处方中26 例高危药品用药错误的原因分析及防范措施
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篇名: 我院门诊处方中26 例高危药品用药错误的原因分析及防范措施
TITLE:
摘要:

目的:为减少乃至杜绝门诊高危药品的用药错误提供参考。方法:收集2013-2014 年我院门诊处方点评中发现的高危

药品用药错误,对用药错误的类型、差错级别和引发差错的因素等进行回顾性分析。结果:2 年共点评处方670 997 张,发现用药

错误501 例,其中高危药品的用药错误26 例,包括胰岛素给药途径错误7 例、口服降糖药重复用药和给药剂量错误各1 例、阿片类

药品和非甾体抗炎药重复用药6 例、氨酚待因适应证错误2 例、葡萄糖注射液规格错误和适应证错误各1 例、利多卡因给药途径错

误2 例、甲氨蝶呤给药频率错误2 例、地高辛给药剂量错误2 例、华法林给药剂量错误1 例。医师处方错误,经药师审核发现错误并

拒绝调配的18 例,占69.2%;医师处方错误而药师未发现的8 例,占30.8%。结论:门诊高危药品的用药错误主要发生在医师处方

环节,主要原因为电子医嘱系统没有实行强制和约束策略。提高门诊高危药品安全用药水平需要找到差错环节并采取靶向性安

全用药方案。

ABSTRACT:

OBJECTIVE:To provide reference for reducing and avoiding medication errors of high-alert drugs in outpatient department.

METHODS:The medication errors of high-alert drugs in outpatient prescriptions were collected from our hospital during

2013-2014,and then analyzed retrospectively in terms of the type and degree of medication error,caused factors of medication errors,

etc. RESULTS:670 997 prescriptions were checked in two years,and 501 medication errors were found,including 26 medication

errors of high-alert medication. There were 7 incorrect route of administration of insulin,1 repeated medication and 1 incorrect

dose of oral hypoglycemic agents,6 repeated administration of opioid drugs and non steroidal anti-inflammatory drugs,2 indication

error of paracetamol and codeine phosphate,1 specification and 1 indication error of glucose injection,2 route of administration

error of lidocaine,2 administration frequency errors of methotrexate,2 dose error of digoxin and 1 dose error of warfarin;18

doctors’prescribing errors were found by pharmacists’prescription audit,accounting for 69.2% ;8 doctors’prescribing errors

were not found by pharmacists’prescription audit,accounting for 30.8%. CONCLUSIONS:Medication errors of high-alert drugs

occur mainly in the prescription segment,and the main reason is that the electronic prescription system lack of compulsory strategy

and policy constraints. Improvement of safety administration of high-alert drugs need to find the error link and adopt targeted medication

safety practices.

期刊: 2015年第26卷第35期
编辑: 马丽萍,吝战权,沈司京
AUTHORS: MA Li-ping,LIN Zhan-quan,SHEN Si-jing
关键字: 门诊处方;高危药品;用药错误;原因分析;防范措施
KEYWORDS: Outpatient prescription;High-alert drugs;Medication errors;Analysis of the cause;Preventive measures
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