李杰萍

[摘要] 总结住院患者常见用药安全问题，系统分析引起用药安全问题的5大因素：工作责任心不强、药理知识缺乏、医护配合不协调、健康宣教不到位以及注意力不集中。针对具体原因采取相应的干预措施：严格执行三查七对、加强工作责任心、加强药理知识的学习、加强医护人员的配合、及时有效地开展健康宣教，以及开展弹性排班制度。通过运用现代化的管理技术和策略，严格按操作流程工作，可将用药差错的发生率降到最低，避免给患者造成伤害。

[关键词] 住院患者；用药安全；综合干预

[中图分类号] R472   [文献标识码] B   [文章编号] 2095-0616（2014）08-147-03

Medication safety issues and comprehensive intervention of inpatients

LI Jieping

Department of Integrative Medicine, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai 264000, China

[Abstract] To summarize the common medication issues of inpatients and analyze 5 major factors leading to the medication issues systematically, including poor sense of work responsibility, lack of pharmacological knowledge, discordant coordination between doctors and nurses, inadequacy of health education and inattention. Corresponding intervention measures were taken directing at specific reasons, including strict enforcement of three investigations and verifications, strengthening sense of work responsibility, enhancing learning of pharmacological knowledge, enhancing doctor-nurse coordination, implementing health education timely and effectively and implementing flexible scheduling system. The application of modern management techniques and strategies and the strict compliance of operation procedures can reduce the incidence of medication errors to a minimum and avoid harming patients.

[Key words] Inpatients; Medication safety; Comprehensive intervention

2004年10月，世界卫生组织(WH0)启动世界病人安全联盟，将安全用药目标定位患者安全目标之一[1]。随着住院患者用药种类的不断增加和自我保护意识的增强，用药安全问题越来越受到护理管理者的重视。国内一项研究显示用药安全有关的缺陷占所有护理缺陷的33.5％[2]，美国住院患者受到医疗伤害的占3.5％，其中因用药疏忽或错误所致占7％左右[3]。护士作为药物治疗的直接执行者和观察者，其行为直接影响患者用药安全[4]。作为患者给药的最后一道屏障，护士在合理用药的每个环节起着举足轻重的作用。现对住院患者用药安全问题进行系统阐述，针对相关问题进行归纳总结，采取干预措施，为临床护士实施及时正确的给药提供参考。

1 常见住院患者用药安全问题

住院患者的用药途径和种类比门诊患者相对复杂，任何一个环节出现疏忽，都可能对患者造成伤害，引发医疗纠纷，现对临床上常见的用药安全问题总结如下：（1）用错药：加入的药物或溶媒使用不正确，以及错用到别人身上。……