臺灣博碩士論文加值系統

一直以來病人安全都是受到重視的，病人安全中用藥安全更是每每被衛生福利部列為醫院醫療品質及病人安全工作目標，在用藥安全的部分中有一部分是管制藥品，這不但醫院病人安全重視，衛福部更有管制藥品條例法規的規範，臨床護理人員給藥時規範更是謹慎，研究如何運用知識管理的觀點，建構一個病房管制藥品作業系統。針對衛福部公布的管制藥品條例、配合醫院相關管制藥品管理程序書以及臨床作業需求設計簡化的病房管制藥品作業系統，運用知識管理的架構進行系統的分析，系統包含與藥局撥發作業無縫界接，並針對病房管制藥品的取藥、點班、稽核、補入、換領流程簡化，減少重覆謄寫資料的時間以及減少紙張的浪費，同時針對四級管制藥品的雙人檢核資訊化，系統也與病房的簽收藥物介面連結提供病人用藥安全，在藥局端也提供管制藥品全院使用明細查詢，最後透過平衡計分卡來針對流程及財務的構面進行分析系統的成效。
本研究發現經過導入知識管理的觀點來建構病房管制藥品作業系統，在取藥的部分每年節省1825小時，點班節省了將近5000個小時，管制藥品異常通報件數比率由2015年的35%降低到2017年的1.03%，達到提升病人用藥安全及減少給藥錯誤，是有效提升用藥安全的一個做法。

Patient safety has always been valued. The safety of medication in patient safety is often listed as a medical quality and patient safety goal by the Ministry of Health and Welfare. Some of the safety aspects of medication are controlled drugs. This is not only the safety of hospital patients. Emphasis is placed on the fact that the Department of Health and Welfare has more regulations on the regulation of drug regulations, and the clinical nursing staff is more cautious in the administration of drugs, and studies how to use the knowledge management perspective to construct a ward-controlled drug operating system. Designed a simplified ward-controlled drug operation system for the regulatory drug regulations promulgated by the Department of Health and Welfare, in conjunction with hospital-related controlled drug management procedures, and clinical operations, using a knowledge management framework for systematic analysis, and the system includes seamless integration with pharmacy allocation operations. In addition, simplification of drug collection, shifting, auditing, replenishment, and redemption processes for ward-controlled drugs, reducing the time for repeated writing of materials and reducing paper waste, and the informationization of double-checking for four-level controlled drugs, The system also provides a patient drug safety link with the pharmacy''s signing drug interface. The pharmacy also provides a detailed query for the use of controlled drugs throughout the hospital. Finally, the balanced scorecard is used to analyze the effectiveness of the system for the process and financial aspects.
This study found that the introduction of knowledge management to construct a ward-controlled drug operating system, saving 1825 hours per year in the drug-receiving portion, saving nearly 5,000 hours on-time, and reducing the number of notified drug abnormalities by 35% in 2015. By 1.03% in 2017, it is an effective way to improve the safety of medications by improving patient medication safety and reducing medication errors.

誌謝 I
摘要 II
目錄 V
圖目錄 VII
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第三節 研究範圍及限制 3
第四節 研究步驟及流程 3
第二章 文獻探討 5
第一節 管制藥品 5
第二節 用藥安全 9
第三節 知識管理 9
第四節 系統建置 11
第五節 知識管理與系統建置 12
第六節 平衡計分卡 13
第三章 研究方法 15
第一節 系統架構 15
第二節 病房管制藥品作業流程說明 16
第三節 藥局管制藥品作業現況分析 19
第四節 護理人員給藥系統分析 20
第四章 管制藥品作業系統建置 22
第一節 管制藥品作業系統建置方式 22
第二節 管制藥品作業系統架構環境 24
第三節 病房管制藥品作業系統分析 26
第三節 管制藥品作業系統建置 32
第四節 後端資訊運用 38
第五節 增加病人安全 38
第六節 系統建置之成效 40
第五章 結論與建議 42
第一節 結論 42
第二節 建議 43
參考文獻 45

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網路資料來源
1.Skyrme, D., Knowledge Management: Making Sense of an Pzymoron, 1997, Retrieved August 1, 2007, from:http://www.skyrme.com/insights/22km.htm
2.全國法規資料庫(2010)·管制藥品條例·取自https://goo.gl/GLeikC
3.衛生署(2017) ·藥物濫用案件暨檢驗統計·取自 https://www.fda.gov.tw/upload/133/2018060611421646746.pdf
4.衛生署(2017)·106年度管制藥品實地稽核結果統計表·取自 https://goo.gl/BkQpXe