社團法人臺灣臨床藥學會

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【原著】臺灣全靜脈營養輸液調劑作業調查與規範之制訂
Survey of the Dispensing Practices for Total Parenteral Nutrition in Taiwan and the Establishment of Guidelines
中央靜脈營養,標準作業規範,無菌製劑調製、Central Parenteral Nutrition, Standard Operation Procedure, Compounded Sterile Preparations
程思偉Ssu-wei Cheng*1 、姜紹青Shao-Chin Chiang2 、許派洲Pai-Chou Hsu2 、鄧新棠Shin-Tarng Deng3 、李孟芸Meng-Yun Lee2 、王春玉Chun-Yu (Mary) Wang11
1新光吳火獅紀念醫院藥劑部 、2和信治癌中心醫院藥劑科 、3林口長庚紀念醫院藥學部
全靜脈營養常見的錯誤包括調劑錯誤、劑量錯誤、標示錯誤及自動調劑設備錯誤。為了減少靜脈營養調劑錯誤造成的危害,訂定一套標準調劑規範確實有其必須性。目前臺灣並沒有官方認可且具體可行的中央靜脈營養輸液調劑作業規範或指引,因此衛生福利部食品藥物管理署委託臺灣臨床藥學會建立臺灣全靜脈營養輸液調劑作業規範及查核機制。
本研究利用問卷調查方法,調查臺灣共151 家醫院之全靜脈營養輸液調劑作業現況,共回收85 分問卷 ( 回收率56%),包含12 家醫學中心 ( 占所回收醫學中心之100%) ,34 家區域醫院 ( 占所回收區域醫院之69%),1 家地區醫院 ( 占所回收地區醫院之4%) 。最後綜合問卷調查結果、專家審查意見、焦點座談會討論,完成規範內容包含營養評估、調劑作業及教育訓練。
 
Common total parenteral nutrition (TPN) errors include dispensing errors, dosage errors, labeling errors,and automatic dispensing device errors. In order to reduce the harm caused by parenteral nutrition dispensing errors, it is necessary to establish a standard for dispensing. Currently, no approved and practical standard operating procedure (SOP) or guidelines for total parenteral nutrition are available in Taiwan, and therefore the Food and Drug Administration (FDA) at the Ministry of Health and Welfare (MOHW) has asked the Taiwan Society of Health-System Pharmacy to establish an SOP and audit mechanism for total parenteral nutrition practices in Taiwan.
In this study, a questionnaire survey was performed to investigate the current status of the dispensing practice for TPN at 151 hospitals in Taiwan. A total of 85 questionnaires were returned (the response rate was 56%), including 12 medical centers (100% response rate from medical centers), 34 regional hospitals (69% response rate from regional hospitals), and 1 district hospital (4% response rate from district hospitals).The survey results, reviewers’ comments from the experts, and discussions from the forums were collected to compile the contents of the guidelines, including nutritional assessments, dispensing practices and educational training programs.
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