護理師準備給予病人多種藥物。哪些因素會增加給藥錯誤的風險?(選所有適合的)
A nurse is preparing to administer several medications to a client. Which factors increase the risk of medication errors? (Select all that apply.)
- ASimilar drug names (look-alike/sound-alike)✓ 正解藥物名稱相似(外觀/聲音相似)
- BHigh workload and environmental distractions✓ 正解高工作負荷與環境干擾
- CVerbal orders provided during emergencies✓ 正解緊急情況下提供的口頭醫囑
- DUsing automated dispensing cabinets (ADC)使用自動發藥櫃(ADC)
- EStandardized electronic health records (EHR) medication lists標準化的電子健康病歷(EHR)用藥清單
用藥安全是 NCLEX 重點,給藥錯誤(Medication errors)常源於系統性問題而非單一錯誤。護理師應具備「用藥安全五權」(Five Rights)觀念,並警覺環境因素。類似藥名(LASA)容易混淆、工作負荷過重導致注意力分散、以及緊急狀況下的口頭醫囑(Verbal orders)皆是高風險因子。在美國臨床環境中,強調將「錯誤」視為系統層面的改善機會(Just Culture),而非僅懲罰個人。
Medication errors most often arise from system-level factors. Look-alike/sound-alike (LASA) drug names, high workload with frequent interruptions, and verbal orders during emergencies are all known contributors. Automated dispensing cabinets (with barcode verification) and standardized EHR medication lists reduce errors and are safety enhancements, not risks.
美國醫院廣泛使用條碼給藥系統(Barcode Medication Administration, BCMA),護理師給藥前必須掃描病人腕帶與藥物條碼,這與台灣目前推廣的流程相似,但在美國為強制性安全標準。