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      关于简论门诊药房常见发药差错及防范措施网站位置: >> 医药学论文 >> 微生物药物学论文 >> 浏览文章
      简论门诊药房常见发药差错及防范措施

      论文导读:房调配差错理由分析及干预措施讨论.中国药物应用与监测,2013,10(2):115-116  斌兰.门诊药房发药差错的理由分析及防范.中国药事,2013,27(10):1108-1109  唐巧萍,王彦东.门诊药房差错理由分析及防范措施.包头医学,2013,37(4):251-252 。ㄊ崭迦掌冢2014.07.28)

      门诊药房常见发药差错及防范措施【摘要】目的:防范门诊药房发药差错,杜绝药疗事故发生。策略:从药品、药师等方面分析门诊药房常见调剂差错,并采取相应的防范措施。结果:确;颊哂靡┌踩、合理、有效。结论:提高药剂人员的服务水平,查找不安全因素,确保为患者提供安全有效的药学服务。
        【关键词】门诊药房;发药差错;防范措施
        1007-8517(2014)19-0132-01
        门诊药房是医院面向社会服务的一个重要窗口,它的优劣不仅在某种程度上反映了药剂科人员的素质和专业水平,而且直接影响到医院的医疗质量和社会声誉。如何减少差错及事故的发生是提高医疗质量、防止纠纷的重要因素[1]。
        1资料与策略
        收集我院2013年1月至12月门诊药房发药差错登记,共记录39例。 对记录在册的理由进行分析并归类,报告如下。
        2结果
        2.1名称相似的药品差错此类差错有6例,占差错的15.4%。名称相似的药品很多,如依那普利与贝那普利,辛伐他汀与洛伐他汀,药师在没有仔细核对处方的情况下,急于调配药品造成发药差错。
        2.2同种药品不同规格的发药差错此类差错有8例,占差错的20.5%。如红霉素肠溶胶囊0.125g和红霉素肠溶胶囊0.25g;阿奇霉素0.5g和阿奇霉素0.25g,若药师调配药品时,不仔细核对药品规格,很容易出现差错。
        2.3有效成分相同,剂型不同的药品差错此类差错有10例,占差错的25.6%。如盐酸左氧氟沙星胶囊和盐酸左氧氟沙星片,头孢克肟分散片与头孢克肟颗粒等。药师在调配药品时,不仔细核对药物剂型,易引发差错。
        2.4包装相似药品差错此类差错有5例,占差错的12.8%。这种情况多出现于同一厂家生产的药品,如我院有某厂家生产的依巴斯汀和爱普列特,这两种药品其作用完全不同,但外包装大小和颜色都极为相似,极易发生药品差错。
        2.5药品数量差错此类差错有10例,占差错总数的25.6%。由于药师劳动强度大,易发生疲劳感,容易把处方中同时存在多种药品的数量看串,发生投药差错。
        3讨论
        药师有时因劳动强度过大,遇到患者较多的高峰时段,药师易产生从速心理,不仔细核对处方,单人发药,不实行双复核制度,把药品直接投出窗口,既容易造成错发药品,又容易导致患者之间取错药品。同时长时间工作易产生大脑疲劳,在疲劳工作状态下导致药品调配差错。外界干扰,药师调配药品时,外界环境吵杂,药师之间相互聊天,患者之间聊天,患者咨询理由等,都会分散药师注意力,导致调配差错。药师工作不熟练,责任心不强,马虎大意,随意摆放药品,发药时没有仔细逐一核对,易造成错发。
        4防范措施
        4.1严格制度健全各项规章制度,严格执行“四查十对”制度,制定药品调配操作规程。好的工作程序对用药安全至关重要,如果药房调剂程序做得足够规范,调配、核对、发药各司其职,那么处方调剂出现差错就会比之前呈几何倍数下降[2]。
        4.2实现药物一品双规在药品多元化的今天,应落实药物一品双规制度,不得随意增加药物的品规数量,从而减少药品调剂差错的发生。
        4.3加强药师培训,提高风险意识在调研中发现,新聘药师和实习学生,发生差错占半数以上,因此,药师岗位培训是提高业务水平的重要手段[3]。全体药剂人员要认识到错发药品的后果和危害性,在发药之前要认真审核处方,不要同时调配多张处方,加强责任心,培训认真细致的工作作风,严格执行双人复核制度,不仅保证患者用药安全,同时也是减少药患纠纷的必要措施。
        4.4减轻工作压力,合理安排窗口人员配备超负荷的工作使药剂人员神经处于高度紧张的疲劳状态,尤其在患者较多的高峰时段,应合理配备窗口人员的数量,开设药物咨询窗口,专门解答患者用药理由,保证药品调剂人员的精力,避开因疲劳、忙乱工作而导致的药品调配差错。
        4.5合理摆放药品,建立警示标志按药理作用将药品进行分类,摆放药品时要确保品名与货架上的标签严格对应(药名、规格、生产厂家)[4],把外观相似容易错发的药品分开摆放,高危药品单独存放。将高危药品、易混淆的药品、近效期药品等建立醒目标志。
        4.6建立发药错误登记、报告制度对发药时出现的各种差错,当事人应及时如实报告,发生严重差错应立即上报上级职能部门及分管领导,并应设立差错事故登记本以及时登记差错。在定期学习中进行分析、总结,以避开相同的差错事故的再次发生。
        5小结
        随着卫生体制改革的不断深入,医疗技术的不断发展,新的技术和新的药物也不断的出现,患者对医院要求越来越高,包括对门诊药房的服务也提出了更高的要求。我们必须提高对药剂人员的服务水平,加强对专业知识的培训,加强对工作技能的提升,加强药品质量的各项管理,查找到任何不安全的因素,确保为患者提供安全有效的优质药学服务[5]。确保用药的安全性、有效性与经济性,同时提高药师的社会地位,体现药师的社会价值。
        参考文献
        [1]薛玉华,杨乃华.谈某院门诊处方差错及防范措施[J].中国医药指南,2011,9(21):379-380
        [2]许虹娟.西药房中确保发药准确的分析[J]. 临床合理用药,2013,6(11):95-96
        [3]栾潇潇,陈珲,李星,等.门诊药房调配差错理由分析及干预措施讨论[J].中国药物应用与监测,2013,10(2):115-116
        [4]斌兰.门诊药房发药差错的理由分析及防范[J].中国药事,2013,27(10):1108-1109
        [5]唐巧萍,王彦东.门诊药房差错理由分析及防范措施[J].包头医学,2013,37(4):251-252
       。ㄊ崭迦掌冢2014.07.28) 全文地址:http://www.abcanuncios.com/wswywxlw/lw50507.html
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