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医生与护士之间临时处方及认知差异

Pro Re Nata Prescription and Perception Difference between Doctors and Nurses.

作者信息

Oh Se Hwa, Woo Ji Eun, Lee Dong Woo, Choi Won Cheol, Yoon Jong Lull, Kim Mee Young

机构信息

Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.

出版信息

Korean J Fam Med. 2014 Jul;35(4):199-206. doi: 10.4082/kjfm.2014.35.4.199. Epub 2014 Jul 25.

Abstract

BACKGROUND

Pro re nata (PRN) prescription is a frequently used prescription method in hospitals. This study was conducted to investigate actual condition of PRN prescription and whether administration error occurred because of perception difference between doctors and nurses.

METHODS

From May to July 2012, a survey was conducted among 746 doctors and nurses (88 doctors and 658 nurses) working at 5 hospitals located in Seoul, Gyeong-gi, and Gangwon Province. Doctors generating PRN prescription responded to actual conditions of PRN prescription and both doctors and nurses reported whether administration error occurred due to perception difference.

RESULTS

Average number of PRN prescription of surgical residents was 4.6 ± 5.4, which was larger than that of medical residents (1.7 ± 1.0). Surgical residents more frequently recorded maximum number of daily intake (P = 0.034) and, although not statistically significant, more often wrote exact single dosage (P = 0.053) and maximum dosage per day (P = 0.333) than medical residents. Doctors expected nurses to notify them before the administration of medication; however, nurses were more likely to conduct PRN administration by their own decision without informing doctors. In addition, some doctors and nurses experienced administration errors because of it.

CONCLUSION

Standard prescription methods need to be established since there is a perception difference in PRN prescription between doctors and nurses and this could be related to administration errors.

摘要

背景

必要时(PRN)处方是医院常用的一种处方方式。本研究旨在调查PRN处方的实际情况,以及医生和护士之间的认知差异是否会导致用药错误。

方法

2012年5月至7月,对首尔、京畿道和江原道5家医院的746名医生和护士(88名医生和658名护士)进行了调查。开具PRN处方的医生反馈了PRN处方的实际情况,医生和护士均报告了因认知差异是否发生用药错误。

结果

外科住院医师的PRN处方平均数量为4.6±5.4,高于内科住院医师(1.7±1.0)。外科住院医师更频繁地记录每日最大摄入量(P=0.034),虽然无统计学意义,但比内科住院医师更常写明确切单次剂量(P=0.053)和每日最大剂量(P=0.333)。医生期望护士在用药前通知他们;然而,护士更倾向于自行决定进行PRN用药而不告知医生。此外,一些医生和护士因此经历了用药错误。

结论

由于医生和护士在PRN处方方面存在认知差异,且这可能与用药错误有关,因此需要建立标准的处方方法。

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