目的 观察门诊处方差错管理方法改进后的效果.方法 (1)通过分析2010年门诊处方差错原因,改进工作流程.一是完善信息化功能:安装了合理用药监控系统和处方预览界面;二是延伸查对内容:在执行“四查十对”的同时,增加核对门诊病历和鼓励患者参与核对;三是打包收费项目,简化医生开单流程;四是加强监督检查.观察改进管理方法前后门诊处方差错发生情况.(2)采用自行设计的调查问卷分别对2010年和201 1年的320例和326例门诊患者进行了满意度调查,并进行对比分析.结果 (1)管理方法改进后,门诊处方差错发生率由4.2％降至1.8％,差异有极显著性(x2=40.07,P＜0.01).(2)患者满意度由83.8％％升高达97.2％,因处方差错引起的纠纷降为0,差异均有统计学意义(x2=34.36,P＜0.01; x2=6.31,P＜0.05).结论 改进后的管理方法明显规范了药品使用,降低处方差错发生率,降低医疗风险和医疗纠纷的发生,提高了门诊医疗质量,提高了患者对医院的信任度和满意度.%Objective To investigate the improvement effect of outpatient prescription error management.Methods (1) To analyze the causes of outpatient prescription errors in 2010 and improve workflow.One was to improve information technology functions:rational drug use monitoring system installed and prescription preview interface; secondly,we checked the contents of the extension:the implementation of "four examinations ten confirmation" while checking patients' medical records and encouragng increased participation of patients' checking; the third was to packag charges projects,simplify physician billing processes; the fourth was to strengthen supervision and inspection.Outpatient prescription errors situation before and after management improvement were observed and compared.(2) Self-designed questionnaire was used to respectively investigate the satisfaction of 320 (2010) cases and 326 (201 l) cases in outpatient department.Results (1) Management improvements,outpatient prescription error rate dropped from 4.2％ to 1.8％,the difference was statistically significant (x 2=0.07,P ＜ 0.01).(2) Patient satisfaction increased from 83.8％％ to 97.2％,due to prescription errors caused by the dispute to 0,the differences were statistically significant (x 2=34.36,P ＜ 0.01; x 2=6.31,P ＜ 0.05).Conclusion The improved management of drug use standardized methods significantly reduce the incidence of prescription errors,and reduce health risks and the occurrence of medical disputes,improve patients' quality of care,and increase patients' trust and satisfaction to the hospital.
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