Safe medication practice: attitudes of medical students about to begin their intern year
Safe medication practice: attitudes of medical students about to begin their intern year
复制标题
DOI：
10.1111/j.1365-2923.2008.03029.x
复制
发表时间：
2008-04-01
影响因子：
6
通讯作者：
Stowasser, Danielle A.
中科院分区：
文献类型：
--
作者：
Coombes, Ian D.;Mitchell, Charles A.;Stowasser, Danielle A.
目标 实习生应能够有效、安全地开处方。本研究旨在评估医学生对处方准备情况、相关风险和错误结果的看法，以及他们对可用支持的看法。方法我们在实习前使用结构化问卷对 101 名学生进行了调查。寻求对 21 份封闭式声明表示同意。通过因子分析确定主题群。 结果 大多数学生 (84) 认为他们能够为最简单的投诉开出处方并完成出院处方 (81)。在高风险情况下，较少的学生对处方感到满意：只有 54 名学生有足够的信心开出华法林处方，66 名学生有足够的信心订购静脉注射药物。液体。许多人认为可以获得指南等支持（87），并且如果有疑问，他们可以澄清说明并寻求建议。学生意识到药物系统内发生的错误；然而，大多数人（99 人）相信他们开出的药物可以安全服用。对用药错误的看法不一：40 名学生认为他们的处方错误不会得到建设性处理，79 名学生表示，他们的医院存在一种文化，即如果临床医生犯了处方错误，他们就会受到指责。 结论 在医学院教育结束时和承担处方责任之前，学生感到没有准备好，并认为如果他们犯了错误，将会导致负面结果。这些发现表明，需要做更多的工作来帮助医生安全开药、提高处方系统的安全性并解决责任问题。
OBJECTIVES Interns are expected to prescribe effectively and safely. This study aimed to assess medical students' perceptions of their readiness to prescribe, associated risks and outcome if involved in an error, as well as their perceptions of available support.METHODS We carried out a survey of 101 students prior to their intern year using a structured questionnaire. An indication of agreement with 21 closed statements was sought. Thematic clusters were identified by factor analysis.RESULTS Most students (84) felt they would be able to prescribe for most simple complaints and complete discharge prescriptions (81). In high-risk situations, fewer students felt comfortable with prescribing: only 54 felt sufficiently confident to prescribe warfarin and 66 felt confident enough to order i.v. fluids. Many felt support such as guidelines was available (87) and that, if in doubt, they could clarify instructions and seek advice. Students were aware of errors occurring within the medication system; however, most (99) believed that the medicines they prescribed would be safely administered. There was a mixed perception of medication errors: 40 felt that their prescribing errors would not be dealt with constructively and 79 indicated that a culture existed at their hospitals where clinicians would be blamed if they made a prescribing error.CONCLUSIONS At the end of medical school education and prior to assuming responsibility for prescribing, students felt unprepared and perceived that negative outcomes would result if they were involved in errors. These findings indicate that much more work is needed to prepare doctors to prescribe safely, improve the safety of prescribing systems and address the issue of blame.