以四正确为核心的三四二二查对体系在减少给药错误中的应用.docVIP

以四正确为核心的三四二二查对体系在减少给药错误中的应用 　　[摘要]目的 探讨“以四正确为核心的三四二二查对体系”在减少给药错误中的应用效果。方法 2015年1～12月我院住院患者数为19782名，2016年1～12月住院患者数为19793名。2016年1～12月我院护士在执行给药的过程中应用“以四正确为核心的三四二二查对体系”进行查对，即将三查、四正确、两种方式查对、两人查对构建成“以四正确为核心的三四二二查对体系”，并绘制成“以四正确为核心的三四二二查对体系图”。比较实施后（2016年1～12月）和实施前（2015年1～12月）的年给药错误发生率及年给药迹近错误发生率。结果 “以四正确为核心的三四二二查对体系”实施后的年给药错误发生率及年给药迹近错误发生率为0.10‰、0.50‰，较实施前（0.45‰、1.60‰）明显降低，差异有统计学意义（P0.05，P0.01）。结论 “以四正确为核心的三四二二查对体系”的应用能有效地减少给药错误。 　　[关键词]四正确；三四二二查对体系；护理查对制度；给药错误 　　[中图分类号] R197.323 [文献标识码] A [文章编号] 1674-4721（2017）10（b）-0152-03 　　[Abstract]Objective To explore the application effect of the “three four two two check system with four right as the core” in the application of decreasing of the medication errors.Methods There were 19782 patients in 2015 and 19793 patients in 2016.The nurses carried out the medicine with the check system in 2016，which were three times check，four rights，two ways，two person check were built into the “three four two two check system with four right as the core”，and were draw into the figure.The incidence of medication errors and near medication errors after （in 2016） and before（in 2015） the application of the check system were compared.Results After the application of the check system，the incidence rate of medication errors and near medication errors were 0.10 ‰ and 0.50 ‰，which were lower than 0.45 ‰ and 1.60 ‰ before the application of the check system，the differences were statistically significant （P0.05，P0.01）.Conclusion The application of the three four two two check system with four right as the core can decrease the medication errors. 　　[Key words]Four rights；Three four two two check system；Nursing check system；Medication errors 　　护士给药错误是指患者实际接受的药物与医嘱之间存在的任何差异[1]。护士是临床给药的直接执行者。文献显示，某医院年发生给药错误为70起，占全年医院护理不良事件的58.7%[2]。谢恩莉[3]调查发现，药物治疗失误占护理差错的78.0%。贾荣娟等[4]的研究显示，2010年某院上报护理部62起护理差错，因查对执行不到位导致给药错误占85.5%。高峰等[5]的研究显示，操作过程中没有认真执行查对制度67例，占给药错误的48.9%。给药错误在护理不良事件中的发生比例居于首位[6]，会威胁到患者的安全，甚至造成患者永久性伤害或死亡。查对制度是保障患者安全的首要措施[7]。为保障护理安全，减少给药错误的发生，让护士更好掌握和应用