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研究生:張慶南
研究生(外文):Chen-Nan Chang
論文名稱:臨床護理人員給藥錯誤及其相關因素探討
論文名稱(外文):A Study on Medication Errors and related factors in Nurses
指導教授:周傳姜周傳姜引用關係
學位類別:碩士
校院名稱:長榮大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:85
中文關鍵詞:護理人員給藥錯誤
外文關鍵詞:NurseMedication Errors
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本研究目的在探討臨床護理人員發生給藥錯誤現況及其相關因素。採橫斷式問卷調查法,研究對象為任職南部三所區域教學醫院之450位護理人員,問卷回收率90.9 %。調查所得資料以SPSS for Windows 10.0進行描述性相關統計分析。
研究結果顯示:研究對象女性佔99.3%,教育程度專科佔一半以上(66%),專業能力進階層級N1佔46.5%最多,69.3%病室有他科病患借住。在護理人員給藥錯誤方面顯示:1. 半年內自己或觀察到他人給藥錯誤類型發生次數前五位為(1) 給藥時間與醫囑不相符;(2) 該給的藥漏給;(3) 給藥速度曾被告知過快或過慢;(4) 沒有醫囑而自行給藥及(5) 給藥途徑與醫囑不相符。2. 半年內自己或觀察到他人給藥錯誤發生原因次數前五位:(1) 護理人員感疲累、體力透支;(2) 醫師手寫醫囑不易辨識;(3) 給藥前未再次核對醫囑;(4) 給藥時被事務中斷或干擾分心及(5) 給藥時未評估病患或家屬對藥物作用副作用瞭解程度。在護理給藥錯誤相關因素方面,本研究發現:1. 平均每週工作(含加班)61-70小時者易發生「給藥時間與醫囑不符」、「護理人員感疲累體力透支」及「醫師字跡潦草不易辨識」、「工作時被事務中斷干擾致分心」。2. 腫瘤病房易發生「給藥時間與醫囑不相符」「醫師手寫醫囑潦草不易辨識」;婦產科病房易發生「給藥前未再次核對醫囑」; 安寧病房易發生「給藥時被事務中斷或干擾致分心」。3. 病室有他科借住易發生「醫師手寫醫囑潦草不易辨識」、「給藥前未再次核對醫囑」。4. 新進人員被指導時間少於1個月與「給藥時間與醫囑不相符」給藥錯誤有顯著相關性。
本研究結果可供護理給藥監控及給藥系統改善之參考。
The purpose of this study was to investigate the current status of medication errors caused by clinical nurses and correlative reasons. A cross-sectional, correctional coefficient design was used. Convenient sampling was employed to recruit 450 clinical nurses from three regional teaching hospitals in Southern Taiwan. The response rate is 90.9%. Data were filed in code and descriptive statistic analysis was conducted by applying SPSS for Windows 10.0
The research result shows: 99.3% of the research samples were female; more than half (66%) graduated from junior nursing college; 46.5% with nurse laddrer I ( N1) ; 69.3% of the wards accepted patients from different departments. The first five types of medication errors found by self or by others within half year were: (1) medication time incompatible with medical order; (2) medicine missed; (3) medication speed too fast or too slow; (4) take medicine by self without medical order; and (5) medication method incompatible with medical order. In regard to medication errors caused by nurses, the first five reasons of medication errors found by self or by others within half year were: (1) nurses feel tired and physical strength exhausted; (2) the handwritten medical order of physician is scratchy and not easy to read; (3) no double check for medical order before medication; (4) medication was interrupted by other affairs and caused distraction and (5) no evaluation on patients or their family members’ understanding about medicine side effect before medication . In the aspect of correlative reasons: 1. Nurse’s with working 61-70 hours (include overtime) weekly tends to cause "medication time incompatible with medical order", "nurse feel tired and exhausted" as well as "physician handwriting scratchy and not easy to read", "interrupted by other affairs during work and cause distraction". 2. Study as per department: oncology ward is more inclined to cause "medication time incompatible with medical order" and "physician handwritten medical order is scratchy and not easy to read"; Maternity ward room tends to cause "no double check for medical order before medication"; Hospice ward tends to cause "interrupted by other affairs and cause distraction during medication". 3. Wards lodged by patients from different departments tend to cause "physician handwritten medical order is scratchy and not easy to read" and "no double check for medical order before medication". 4. New staff with training time less than one month are significantly related to the medication error of “medication time incompatible with medical order” .
This research result provides a reference for improving nurse medication supervision and medication system.
中文摘要 I
英文摘要 II
誌 謝 IV
目 錄 V
表目錄 VII
圖目錄 VIII
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 4
第三節 名詞解釋 5
第二章 文獻探討 6
第一節 給藥錯誤概念 6
第二節 護理人員給藥錯誤的類型、原因及影響 9
第三節 護理人員給藥錯誤相關因素 15
第三章 研究方法 20
第一節 研究架構 20
第二節 研究設計 23
第三節 研究對象 24
第四節 研究工具 25
第五節 資料收集處理與分析 30
第四章 研究結果 33
第一節 護理人員基本屬性 33
第二節 護理人員發生給藥錯誤情形 41
第三節 護理人員給藥錯誤之相關因素 48
第五章 討論 53
第一節 研究對象背景 53
第二節 護理人員給藥錯誤現況及其相關因素 55
第六章 結論與建議 67
第一節 結論 67
第二節 研究限制與建議 69
參考資料 71
中 文 71
英 文 74
附 錄 79
附錄ㄧ 臨床護理人員給藥錯誤調查問 80
附錄二 專家效度名 83
附錄三 參與研究說明 84
附錄四 臨床試驗證 85
中文
史麗珠(2003)•描述性統計、中央極限定理、t分佈•於史麗珠 編著,進階應用生物統計學 (3-20頁)•台北:學富文化事業公司。
伍麗珠、林麗英、周惠千(2005)•某醫學中心護理人員給藥錯誤通報情形之調查研究•醫保研究雜誌,1(1),11-19。
李麗傳、陳彩鳳(2001)•某病房剩藥處理改善方案•護理行政專案(初版,320-338頁)•台北:華杏。
李春蘭、曾修儀、徐珊珊、楊克平、李麗傳(2002)•藥物處理錯誤的探討•領導護理,5(1),79-85。
呂旻芬(2006)•運用HELPS模式探討影響護理人員給藥疏失之因素•未發表的碩士論文,台南:國立成功大學管理學院高階管理碩士在職專班碩士論文。
邱文達、石崇良(2004)•病人安全與醫療倫理-建構以病人為中心的醫療體系•台灣醫學人文學刊,5(2),66-96。
林麗華、黃令宜、蔡欣玲(2006)•護理人員給藥錯誤認知之探討•榮總護理,23(2),171-179。
林秋分、陳玉枝、張文英、高靖秋、林月桂、盧美秀(2005)•醫療照護疏失原因之探討•長庚護理,16(1),23-34。
林淑琴、施惠玲、陳淑芬、郭宜中、曾修儀(2002)•改善急診室留觀病人給藥正確率•醫院,35(1),24-32。
侯勝茂、陳欣欣、石崇良(2005)•病人安全通報系統之國際趨勢•台灣醫學,9(1),48-52。
陳玉枝(2004)•從護理照護層面談病人安全•臺灣醫學,8(4),528-534。
陳淑賢、王昭慧、蘇淑芳、巫菲翎(2005)•某醫學中心住院病童給藥作業之改善•新台北護理期刊,7(1),65-72。
莊美華、林俊龍、王昱豐、曹汶龍、梁育彰(2003)•醫療機構用藥疏失之探討•慈濟醫學,15(4),247-258。
張秉宜(2005)•護理給藥錯誤之研究•未發表的碩士論文,台北:國立台灣大學公共衛生學院醫療機構管理研究所碩士論文。
許慧玉(2004)•護理人員對給藥錯誤認知之探討•未發表的碩士論文,高雄:高雄醫學大學護理學研究所碩士班碩士論文。
郭美玲(2005)•護理人員對用藥安全與用藥安全通報認知及用藥安全執行之研究•未發表的碩士論文,高雄:高雄醫學大學公共衛生學研究所醫務管理碩士在職專班碩士論文。
黃瑞蘭(2004)•住院病患給藥安全調查研究-以某區域教學醫院為例•未發表的碩士論文,高雄:高雄醫學大學健康科學院公共衛生學研究所醫務管理碩士在職專班碩士論文。
楊秀儀(2003)•醫院之醫療糾紛責任風險預估與因應策略探討•醫務管理期刊,4(2),37-55。
劉侃(2006)•運用失效模式與效應分析技術及資訊科技改善用藥安全•未發表的碩士論文,高雄:高雄醫學大學健康科學院醫務管理學研究所在職專班碩士論文。
Jesper Poulsen (2003,2月)•病患傷害之流行病學探討•於中華民國醫師公會全國聯合會,如何建構病患安全環境研討會會議實錄•台北、中華民國:台北青少年育樂中心。
財團法人醫院評鑑暨醫療品質策進會(2004)•病患安全•2004年5月18日取自http://www.ticha.org.tw/safe/safe_body0303.asp
財團法人醫院評鑑暨醫療品質策進會(2007)•病患安全•2007年2月18日取自http://www.ticha.org.tw/news/9596_TARGET.pdf,2007
程金瀛、劉淑娟(2004)•預防老人用藥錯誤-護理的角色與功能•長期照護雜誌,8(4),408-414。

英文
Aiken,L.H.,Clarke,S.P.,Sloane,D.M.,Sochalski,J.,& Silber,J.H.(2002).Hospital nurse staffing and patient mortality,nurse burnout,and job dissatisfaction.journal of American Medical Association.228(16),1987-1993.
American Society of Hospital Pharmacists (1993). ASHP guidelines on preventing medication errors in hospitals. American Journal of Hospital Pharmacy, 50, 305-314.
Antonow, J. A., Smith, a. b., & Silver, M. P. (2000). Medication error reporting: a survey of nursing staff. Journal Nursing of Care Quality, 15(1), 42-48.
Barken, K. N., Flynn, E. A., & Pepper, G. A. (2002). Medication errors observed in 36 health care facilities. Arch Intern Med,162,1897-1903.
Beyea, S., Killen, A., & Berland, J. (2002). Lesson about patient safety frim Jean Reeder: patient safety First. AORN J, 76(2), 318-319.
Bindler, R. & Bayne, T. (1984). Do Baccalaureate students possess basic mathematics proficiency. Journal of Nursing Education, 23(5), 192-197.
Blais, K. & Bath, J. B. (1992). Drug calculation errors of Baccalaureate nursing student. Nursing Educttor, 17(1), 12-15.
Blegen, M. A., Vaughn, T. E., & Goode, C. J. (2001). “Nurse experience and education: effect on quality of care”. J. Nurs. Adm., 31(1), 33-38.
Boggs, P., Brown-Molnar, C.S. & De Lapp, T.D. (1988). Nurse’s Drug Knowledge. Western Journal of Nursing, 10 (1), 84–93.
Brown, M. M. (2001). Managing medication error by design. Crit Care Nurs Q, 13(46), 77-97.
Calliari, D. (1995). The relationship between a calculation test given in nursing orientation and medication errors. Journal of Continuing Education in Nursing, 26(1), 11–14.
Calabrese, A. D., Erstad, B. L., & Brandl, K.(2001). Medication administration errors in adult patients in the ICU. Intensive Care Med, 127,1592-1598.
Cooper, M. C. (1995). Can a zero defects philosophy be applied to drug errors?Journal of Advanced Nursing, 21(3), 487-491.
Edgar, T. A., Lee, D. S., & Cousins, D. D. (1994). Experience with a national Medication error reporting program. American journal of Hospital pharmacy, 51(10), 1335-1338.
Fuqua, R. A., & Stevens, K. R. (1988). What we Know about medication errors: a literature review. Journal Nurs Qual Assur, 3(1), 17.
Girotti, M. J., Garrick, C., Tierney, M. G., Chesnick, K., & Brown, S. J. L. (1987). Medication administration errors in an adult intensive care unit. Heart & Lung, 16(4), 449-453.
Gladstone, J. (1995). Drug administration errors: a study into the factors underlying the occurrence and reporting of drug errors in a district general hospital. Journal of Advanced Nursing, 22(4), 628-637.
Grasha, A. F., & O‘Neil ,M.(1996).Cognitive processes in Medication Errors. US Pharm.21,122-132.
Gregg. (2003). Patient Safety and Quality Improvement Act of 2003 108th 1st Session Calendar NO.387.Retrieved July 15,2005,from http://www.sen.ca.gov/speier.
Hackel, L. T., Butt, L.,& Gaurdia, B.(1996).How nurses perceive medication errors. Nursing Management,27(1), 31-34.
Helmreich, R. L.(2000). On error management: lessons from aviation. British Medical Journal,320(7237), 781-785.
Henneman, P. L., Blank, F. S., Smithline, H. A., Li, H., Santoro, J. S., & Schmidt, J.(2006).Voluntarily reported emergency department errors. Journal of patient safety,1(3), 126-132.
Hughes, R. G., & Ortiz, E. (2005). ”Medication Errors”, Why they happen, and how they can be prevented. AJN,105, 14-24.
Hume, M. (1999). Changing Hospital culture systems reduce drug errors. Exec Solut Healths Manage,2(4), 4-9.
Jones, J. J., & Brown, R. M. (1986). A survey of the 12-hour nursing shift in 25 North Carolina hospitals. Nursing Management, 17(5), 27-28.
Kaushal, R., & Bates, D. W. (2002).information technology and medication safety,What is the benefit?Qual a saf Health Care, 11,261-265.
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (1999). To Err is Human: Building a Safer Health System. Institute of Medicine Report. Washington, DC: National Academy Press.
Kohn, L. J., Corrigan, J. M., & Donaldson, M. S. (2000). Preventing medication errors through a systems approach: JCAHO release Sentinel Event Alert. RN Update, 3I(3), 3.
Lassetter, J. H., & Warnick, M. L. (2003). Medical errors, drug-related problems, and medication errors. Journal of Nursing Care Quality, 18(3), 175-181.
Leape, L. L., Bates, D. W., Cullen, D. J., Coper, J., Demonaco, H. J., & Gallivan, T. (1995). Systems analysis of adverse drug events. Journal of the American medical Association, 274(1), 35-43.
Lesar, T. S., Briceland, L., & Stein, S. (1997). Factors related to errors in medication prescribing. JAMA, 277(4), 312-316.
Liang, B. A., & Coulson, K. M. (2002). Legal issues in performing patient safety work. Nursing Economics, 20, 118-125.
Markowitz, J. S., Pearson, G., Kay, B. G., & Loewenstein, R. (1981). Nurses, physicians, and pharmacists: their knowledge of hazards of medications. Nursing Research, 30(6), 366-370.
Mayo, A. M., & Duncan, D. (2004).“Nurse perceptions of medication errors: what we need to know for patient safety”. Journal of Nursing Care Quality, 19(3), 209.
Meurier, C. E. (1997). Learning from errors in nursing practice. Journal of Advanced Nursing, 26, 111-119.
Meyer, G., Lewin, D., & Eisenberg, J. (2001). To Err is Preventable; Medical Errors and Academic Medicine. Am J Med, 110(7), 597-603.
Nation Coordinating Council for Medication error reporting and Prevention (NCCMERP)(n.d.).what is a Medication error?Retrieved june29,2005.from http://www.nccmerp.org/aboutMedErrors.html.
Osborne, J., Blais, K., & Hayes, J. (1999). Nurses perceptions: when is it a medication error?Journal of Nursing Administration, 29(4), 33-38.
O’Shea, E. (1999). Factors contributing to medication errors: a literature review. Journal of Clinical Nursing, 8(5), 496-504.
Quality Interagency Coordination Task Force. February (2000).30
Raju, T. M., Kecskes, S., Thornton, J. P., & Perry, M. (1989). Medication errors in neonatal pediatric intensive-care units. Lancet, 12, 374-376.
Ridge, H. E., & While, A. E. (1995). Neonatal nursing staff time involved with medication-related activities. Journal of Advanced Nursing, 22(4), 623-627.
Roseman, C., & Booker, J. M. (1995). Workload and environmental factors in hospitial medication errors. Nursing Research, 44(4), 226-230.
Smith, D. S., & Haig, K. (2005). Reduction of adverse drug events and medication errors in a community hospital setting. Nursing Clinics of North America, 40(1), 25-32.
Van den Bemt, P. M., Fijn, R., Van der Voort, P. H., Gossen, A. A., Egberts, T. C., & Brouwers, J. R. (2002). “Frequency and determinants of drug administration errors in the intensive care unit”. Critical Care Medicine, 30(4), 846-850.
Vincent, C., Neale, G., & Woloshynowych, M. (2001). Adverse events in British hospitals: Preliminary retrospective record review.BMJ,322,517-519.
Vincent, C. (2003). Patient safety:Understanding and responding to adverse events.The New England Journal of Medicine.348(11),1051-1056.
Walters, J. A. (1992). Nurse’s perceptions of reportable medication errors and factors that contribute to this occurrence. Applied Nursing Research, 5(2), 86-88.
Winslow, E. H., Nestor, V. A., Davidoff, S. K., Thompson, P. G., & Borum, J. C. (1997). Legibility and completeness of physicians handwritten medication order, Heart & Lung. The Journal of Acute& Critical Care, 26(2), 158-164.
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1. 伍麗珠、林麗英、周惠千(2005)•某醫學中心護理人員給藥錯誤通報情形之調查研究•醫保研究雜誌,1(1),11-19。
2. 伍麗珠、林麗英、周惠千(2005)•某醫學中心護理人員給藥錯誤通報情形之調查研究•醫保研究雜誌,1(1),11-19。
3. 林麗華、黃令宜、蔡欣玲(2006)•護理人員給藥錯誤認知之探討•榮總護理,23(2),171-179。
4. 林麗華、黃令宜、蔡欣玲(2006)•護理人員給藥錯誤認知之探討•榮總護理,23(2),171-179。
5. 林淑琴、施惠玲、陳淑芬、郭宜中、曾修儀(2002)•改善急診室留觀病人給藥正確率•醫院,35(1),24-32。
6. 林淑琴、施惠玲、陳淑芬、郭宜中、曾修儀(2002)•改善急診室留觀病人給藥正確率•醫院,35(1),24-32。
7. 陳玉枝(2004)•從護理照護層面談病人安全•臺灣醫學,8(4),528-534。
8. 陳玉枝(2004)•從護理照護層面談病人安全•臺灣醫學,8(4),528-534。
9. 莊美華、林俊龍、王昱豐、曹汶龍、梁育彰(2003)•醫療機構用藥疏失之探討•慈濟醫學,15(4),247-258。
10. 莊美華、林俊龍、王昱豐、曹汶龍、梁育彰(2003)•醫療機構用藥疏失之探討•慈濟醫學,15(4),247-258。
11. 楊秀儀(2003)•醫院之醫療糾紛責任風險預估與因應策略探討•醫務管理期刊,4(2),37-55。
12. 楊秀儀(2003)•醫院之醫療糾紛責任風險預估與因應策略探討•醫務管理期刊,4(2),37-55。
13. 程金瀛、劉淑娟(2004)•預防老人用藥錯誤-護理的角色與功能•長期照護雜誌,8(4),408-414。
14. 程金瀛、劉淑娟(2004)•預防老人用藥錯誤-護理的角色與功能•長期照護雜誌,8(4),408-414。
 
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