護理師準備為病人注射靜脈抗生素。哪些護理行為能確保給藥安全?(選所有適合的)
The nurse is preparing to administer an intravenous antibiotic to a client. Which actions by the nurse ensure safe medication administration? (Select all that apply.)
- AVerify the client's identity using two unique identifiers✓ 正解使用兩種獨特的識別方式來驗證病人身份
- BCheck the client's allergy band and electronic health record✓ 正解檢查病人的過敏手環與電子病歷
- CAdminister the medication within 60 minutes of the scheduled time✓ 正解在預定時間 60 分鐘內給予藥物
- DCalculate the infusion rate and double-check with another nurse計算輸注速率並請另一位護理師複查
- EAssess the IV site for signs of infiltration or phlebitis✓ 正解評估靜脈穿刺處是否有滲出或靜脈炎的跡象
給藥安全是護理管理的基石,主要遵循「五對」或「七對」原則。首先,使用兩種唯一識別碼(如姓名、生日或病歷號)核對身份(A)是防止病人錯誤的第一道防線。其次,對於抗生素等高過敏風險藥物,核對過敏史(B)至關重要。第三,給藥時間應符合醫院規範,通常在預定時間的前後 30 至 60 分鐘內給予(C)被視為準時。第四,給藥前評估注射部位(E)可預防藥物外滲造成的組織損傷,這也是靜脈給藥的標準流程。至於選項 D,除非是高風險藥物(如胰島素、肝素或化療藥),否則一般抗生素不需要雙人核對(Double-check),過度要求雙人核對會降低工作效率且不符合成本效益。護理師應專注於落實每一項標準操作程序(SOP),以達成病患安全的目標。
Safe medication administration requires verifying the client's identity using two unique identifiers and checking for allergies to prevent adverse reactions. The nurse should also assess the IV site for infiltration or phlebitis before infusion and administer the medication within the facility's acceptable time window, typically 30 to 60 minutes of the scheduled time. Routine antibiotics generally do not require a second nurse to double-check the infusion rate unless specified as high-alert medications.
美國醫院普遍使用條碼給藥系統 (BCMA),要求給藥前掃描病患手環與藥物條碼,這能大幅降低人為核對疏漏;台灣雖多數醫學中心已引進條碼系統,但在基層或部分診所仍依賴人工口頭核對,程序嚴謹度略有差異。