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安全用药处方:大型教学医院医学生和住院医师的培训与经验

Safe medication prescribing: training and experience of medical students and housestaff at a large teaching hospital.

作者信息

Garbutt Jane M, Highstein Gabrielle, Jeffe Donna B, Dunagan William Claiborne, Fraser Victoria J

机构信息

Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA.

出版信息

Acad Med. 2005 Jun;80(6):594-9. doi: 10.1097/00001888-200506000-00015.

Abstract

PURPOSE

To assess medical students' and housestaff's knowledge, attitudes, and behaviors regarding safe prescribing.

METHOD

In 2003, 214 housestaff (interns and residents) and 77 medical students in medicine and surgery at Barnes-Jewish Hospital, St. Louis, Missouri, were asked to complete an anonymous, self-administered questionnaire about safe prescribing. Questions asked about training in and attitudes about safe-prescribing and current prescribing behaviors. Fisher exact test was used to compare attitudes and behaviors among subgroups.

RESULTS

Of the 175 (60%) respondents, 73 (59%) of 123 housestaff and eight (15%) of 52 students agreed that their safe-prescribing training was adequate (p < .001), and 145 (83%) total respondents agreed that prescribing errors were unacceptable. Respondents reported always doing the following: 156 (89%) checked prescribing information before prescribing new drugs, 131 (75%) checked for drug allergies, 103 (59%) double-checked dosage calculations, 98 (56%) checked for renal impairment, and 53 (30%) checked for potential drug-drug interactions.

CONCLUSION

Routine use of safe medication prescribing behaviors among housestaff and medical students was poor. Contributing factors may have included inadequate training and a culture that does not support safe prescribing. Effective strategies to increase safe medication prescribing need to be identified and implemented.

摘要

目的

评估医学生和住院医师在安全处方方面的知识、态度和行为。

方法

2003年,密苏里州圣路易斯市巴恩斯-犹太医院的214名住院医师(实习生和住院医生)以及77名医科和外科专业的医学生被要求填写一份关于安全处方的匿名自填问卷。问题涉及安全处方的培训、态度以及当前的处方行为。采用Fisher精确检验比较各亚组之间的态度和行为。

结果

在175名(60%)受访者中,123名住院医师中有73名(59%),52名学生中有8名(15%)认为他们的安全处方培训是充分的(p <.001),145名(83%)总受访者认为处方错误是不可接受的。受访者报告总是会进行以下操作:156名(89%)在开新药前检查处方信息,131名(75%)检查药物过敏情况,103名(59%)复核剂量计算,98名(56%)检查肾功能损害情况,53名(30%)检查潜在的药物相互作用。

结论

住院医师和医学生在安全用药处方行为方面的常规表现较差。促成因素可能包括培训不足以及不支持安全处方的文化氛围。需要确定并实施有效的策略来增加安全用药处方。

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