Origin Analysis And Countermeasure Research Of Unsafe Medication Behavior In Clinic

With methods of literature summary, expert consultation, qualitative analysis, cluster analysis and so on, our research formulated a target system to apply to observe clinical medication behavior in large-scale medical establishment, including 11 items involved the observation rarget in PASS,25 items not involved and 12 items about the re-evaluation connection factor of medicine, personnel and external factors.With the aid of good information management system, smooth reasonable medication observation system and numberous medicine data resources of general hospitals, this research used the method of case-observation in epidemiology to carry out the inverstigation with multi-central and large samples of origin analysis of unsafe medication behavior in clinic in large-scale medical establishment the first time in domestic. With the unified observation target, professional clinical pharmacists deeply in clinic carried on real-time tracing and clinical observation of drug use in the couryard patients. The related data come from three representative medical establishments, and the data of 4910 cases of the couryard patients and 219700 medical advices had been collected in 8 months, the key cases of which were analysed following whole process. Through tracing record of unreasonable drug use in order to analyse and judge factors of unsafe medication. Our research would fill in the blanks of investigation data with large samples about unsafe medication behavior and its origin analysis in clinic in domestic.The results of quantitative analysis of the data in our study show that as follows:1) The issues about clinical safe drug use mainly focus on wrong methods of dispensing, drug selections without indications, excessively high beginning of drug use, wrong time-gap of drug use, and so on; there was 23.68 percent in 4910 cases about unreasonable and unsafe drug use.2) Over half of clinical medical advices were submitted overcoming obstacle in the PASS examination, while its advantages of high efficiency and batch process were of accurate practical significance in dealing with rapid trial of massive medical advices in short-time and prompting possible risk.3) The data of key cases show that irregular process of medical advices implementation would obviously increase security risks (23.68%).4) During medicine cures, immediate cause of frequent unsafe behavior was about personnel. Therefore, clinicians doing on their duty is the determining factor of safeguarding clinical medication security, while it is also important to enhanse nurses'skills to avoiding risk of drug use; the function of implements of clinical pharmacist system and augment of the medical team role would be remarkable to reduce clinical unsafe medication. The results from the research were real reaction of present situatin about clinical drug use, and could provide credible data support for related departments to formulate management plans of safe drug use in hospital.This study specially researched and developmented the sofeware routine, named "monitoring and appraisal of drug use safety in hospital", that built good foundation for investigation implemented smoothly; each function of it was designed according to request of this investigation for monitoring and recording situations of drug use safety and appraisal of related factors with unified standard and lots of true data for convenient statistics later. The functions of the sofeware also applied to monitor clinical drug use safety for medical personnel in medical establishments during common works.Combining above results of qualitative and quantitative analysis, our research explored guard countermeasure of clinical drug use safety in medical establishments, and proposed to establish a system of mornitoring and controlling drug safety. On the base of mornitoring and management of the government and management actions about medicine matter of medcial establishments, guard countermeasure of clinical drug use safety in medical establishments should be formulated combining specific performance of clinical drug use unsafety behavior. The countermeasure would be the follows:1) To clear the duty of clinician.2) To improve the comprehensive quality of nursing staff.3) To exploit medicine service and function of safety management regarding clinical pharmacist as the main, such as examination of medical advices, clinical consultation, medication consultation, medication education, TDM, ADRM, PIVA, informationization construction, and so on.