醫院執業藥師避免調劑錯誤之行為意圖研究

A Study on the Hospital Pharmacists' Intentions of Avoiding Dispensing Errors

10.29681/PCJHM.201206.0003

簡盟松(Meng-Song Chian)；潘豐泉(Feng-Chuan Pan)；陳秋榮(Chin-Lung Chen)

藥師 ； 計畫行為理論 ； 調劑錯誤 ； 跡近疏失 ； Pharmacist ； Theory of planned behavior ； Dispensing errors ； Near miss

寶建醫護與管理雜誌

10卷1期（2012 / 06 / 01）

5 - 22

繁體中文

「病人安全」之議題，由於醫療疏失事件造成的傷害與死亡頻傳，廣泛受到討論與重視。減少醫療錯誤、提昇病人安全是各醫療體系改革的重要方向之一。病人用藥，起至藥廠生產藥品、醫師處方、藥師調劑、護理師給藥、至病人使用，環環相扣，任何一環都攸關用藥安全與病人安全。醫院藥師之調劑工作，與醫院藥師工作績效表現，亦關係著醫療品質與病人權益。藥師之績效，最重要者莫過於正確，亦即是避免調劑錯誤的情形發生。根據計畫行為理論，本研究之目的即在於探討醫院執業藥師避免調劑錯誤之態度、主觀規範、與自覺控制能力對其避免調劑錯誤之行為意圖的影響。本研究以結構式問卷收集424份醫院藥師之資料，以SPSS統計軟體進行分析。研究結果發現，醫院藥師之人口統計變項對避免調劑錯誤之態度、主觀規範、自覺控制能力、與行為意圖，具有部分顯著差異；避免調劑錯誤之態度、主觀規範、自覺控制能力對行為意圖均具有正向影響，其中以主觀規範之影響效果最大。本研究亦證實整合所有計畫行為理論之自變項對避免調劑錯誤行為意圖之解釋力，優於任一單一自變項。本研究除對未來研究提出加入其他變項與對主觀規範在行為意圖之角色作後設分析研究之建議外，實務上亦建議強化主管對部屬之同理心、改善工作負荷與輪調、整理整頓工作場域、營造院內和諧關係、與建構不懲罰的調劑疏失自動通報系統等。

Issues on Patient Safety received ever increasing concern due to some severe injuries and deaths that caused by medical errors or negligence in recent years. How a healthcare institutes can reduce medical errors, improve a patient's safety had become one of the top priorities of the entire healthcare system. A chain of drug use may start from pharmaceutical producing, physician prescribing, pharmacist dispensing, nurses distributing, and to the patient consuming. Any errors in the chain will constitute significant threat to the drug safety and the hospital's reputation. The job of dispensing is located in the middle of the entire chain, and thus was characterized with uncertainties, highly time pressure and job stress. Based on the theory of planned behavior, the purpose of this research was to explore how the pharmacists' attitude toward, subjective norm of, and perceived behavior control over avoiding dispensing errors can affect their avoiding intentions. This research collected 424 responses from hospital pharmacists. Major findings are: the main constructs of the model may significantly different in terms of some demographic factors, such as age and education; each independent variables, attitude, subjective norm, and perceived behavior control had positive impacts on the avoiding intentions. However, a model that integrated these variables had better power in explain the pharmacists' error-avoiding behavioral intentions, among which the subject norm represented the most part of the variance. This research concluded with providing good evidence for the theory of planned behavior, and provided several academic and managerial suggestions.