研究医院西药房发药差错常见原因的分析及改进措施

Analysis of Common Causes and Improvement Measures for Errors in Drug Delivery in Western Pharmacies

目的探究医院西药房发药差错事件的原因,并对此进行改进以提升发药质量。方法我院于2018年2月开始针对西药房发药差错事件因素进行分析并实施改进措施,择取2017年4月至2018年1月期间我院药房为其发药的600例患者,以及2018年2月至2018年12月期间我院药房为其发药的600例患者,对其发药差错事件进行统计并分析造成差错的原因,提出并实施改进措施。对改进措施实施前后患者发药差错事件发生率以及差错原因发生率进行比较。结果改进措施实施前我院西药房发药差错事件发生率为11.33%,改进措施实施后我院西药房发药差错事件发生率为2.33%,差异有统计学意义(P<0.05);改进措施实施后因药师、患者自身、医护人员等因素造成的差错事件发生率相比改进措施实施前均有明显下降,差异有统计学意义(P<0.05)。结论造成医院西药房发药差错事件的主要因素与药师业务能力、患者自身因素、医护人员因素等均有一定关系,其中药师业务能力底下,缺乏专业素养是造成发药差错事件的主要因素,需要医院针对发药差错事件发生原因进行充分分析,针对性制定改进措施才能降低发药差错事件风险,保证患者用药安全以及临床疗效,这对医院树立良好的社会形象也有积极影响。

Objective To explore the causes of errors in the drug delivery in western hospital pharmacies,and to improve this to improve the quality of drug delivery.Methods In February 2018,our hospital began to analyze the factors affecting the error in the western pharmacy and implemented improvement measures,and selected 600 patients who were given medicines in our hospital from April 2017 to January 2018,and During the period from February 2018 to December 2018,600 patients who were given medicines in our hospital pharmacy statistically analyzed the causes of errors and analyzed the causes of the errors,and proposed and implemented improvement measures.The incidence of errors and the incidence of errors in patients before and after the implementation of improvement measures were compared.Results Before the implementation of the improvement measures,the incidence rate of errors in the western pharmacy of our hospital was 11.33%.After the implementation of the improvement measures,the incidence of error in the western pharmacy of our hospital was 2.33%,the difference was statistically significant(P<0.05);The incidence of error events caused by factors such as pharmacists,patients themselves,and medical personnel was significantly lower than that before the implementation of improvement measures,and the difference was statistically significant(P<0.05).Conclusion The main factors causing the error in the drug delivery in the western pharmacy of the hospital are related to the pharmacist’s business ability,the patient’s own factors,and the medical staff’s factors.Among them,the lack of professional literacy is the main factor causing the error of the drug.It is necessary for the hospital to fully analyze the causes of the errors in the drug delivery,and to formulate improvement measures in order to reduce the risk of drug error events and ensure the safety of patients and clinical efficacy,which has a positive impact on the establishment of a good social image of the hospital.