张彩梅　章雪莲　葛争丽

[摘要] 目的 找出给药近似错误的影响因素，从根本上降低给药近似错误的发生率。方法 对某三级医院给药近似错误的181例案例进行回顾性分析。结果 给药近似错误发生率在调查期内逐年下降；药物错误、剂量错误在给药近似错误中的比例占60%以上；药物准备阶段发生近似错误的比例占60%以上；90%以上给药近似错误发生在白天；职称、工作年限和系统设备对降低给药近似错误有重要影响；不遵守工作流程、违反操作规程、因干扰工作连续性中断、沟通缺乏、粗心疏忽、记忆错误、药品相似性、信息系统信号差等因素是造成给药近似错误的主要原因。结论 规范给药管理制度，将给药管理视为整体，实行全员的“Five Rights”管理。

[关键词] 给药管理；给药近似错误；给药错误；影响因素

[中图分类号] R192.6 [文献标识码] C [文章编号] 1673-9701（2014）23-0096-04

[Abstract] Objective To find the approximate error factors influence of dosing， fundamentally reduce the administration of approximate error. Methods According to the three level of hospital administration approximation error of 181 cases were retrospectively analyzed. Results The following factors were caused drug similar mistakes.Administration of the approximation error incidence decreased year by year during the investigation. Medication errors and errors in the approximation， error dose administered in the proportion accounted for more than 60%. More than 90% administration of the approximation error occurs during the day. The title， length of service and equipment have important effects on reducing drug approximation error， do not comply with the work flow， violating the operating rules， because of interference interrupts the continuity， the lack of communication， carelessness， memory errors， drug similarity， difference signal information system. Conclusion Specification for dug management system， the administration management as a whole， the full implementation of the "Five Rights" management.

[Key words] Administration management； Administration of the approximation error； Medication errors； Influencing factors

给药近似错误是指在药品采购、供应、医嘱、转抄、调配和发放流程中一个或多个环节中出现的错误，但该错误被及时发现并予以纠正，患者最终没有接受错误的药物治疗。随着社会的发展，越来越多的患者日益重视他们所接受的医疗服务的安全和质量，但基于医院常规的给药过程难免会出现给药错误，常规的给药是通过医生开具医嘱-医嘱转录-药物配置-给药这几个过程实现。给药差错可发生在药品流通的各个环节，如处方、调配和给药、药物监测阶段[1]。以上任一环节出现错误未被及时纠正，患者就得不到安全有效的治疗，有可能承受痛苦及经济损失，重者伤残甚至死亡[2]。……