24/12/25Da-YouWang,HuashanHospital1用药错误及其防范复旦大学附属华山医院王大猷上海200040Wangdayou@hotmail.com24/12/25Da-YouWang,HuashanHospital2提要一、引言二、ME的定义三、危害四、分类五、原因六、因素七、防范对策八、政府干预的建议九、结语24/12/25Da-YouWang,HuashanHospital3…bearinginmindthepreviousreportonthesubject,thathighlightchallengesrelatedtotheinternationaltradeagreements,accesstoessentialdrugs,drugqualityandrationaluseofmedicines,togetherwiththeurgentneedtoimproveaccesstotreatingpriorityhealthproblemssuchasmalaria,childhoodillnesses,HIV/AIDSandtuberculosis,amongothers;REQUESTSDirector-General:…(3)toprovidesupportforimplementationofdrugmonitoringsystemsinorderbettertoidentifydevelopingresistance,adversereactionsandmisuseofdrugswithinhealthsystems,thuspromotingrationaluseofdrugs;(6)toprovidesupporttoMemberStatestosetupefficientnationalregulatorymechanismsforqualityassurancethatwillhelpensurecompliancewithgoodmanufacturingpractices,bioavailabilityandbioequivalenceWorldHealthAssemblyresolution54.11,21May2001:WHOMedicinesStrategy24/12/25Da-YouWang,HuashanHospital4…Concernedthattheincidenceofadverseeventsisachallengetoqualityofcare,asignificantavoidablecauseofhumansuffering,andhightollinfinanciallossandopportunitycosttohealthservices;Notingthatsignificantenhancementofhealthsystems’performancecanbeachieved…bypreventingadverseeventsinparticular,andimprovingpatientsafetyandhealthcarequalityingeneral;REQUESTSDirector-General:…(1)todevelopglobalnorms,standardsandguidelinesforthedefinition,measurementandreportingofadverseevents...,andtoprovidesupporttocountriesindevelopingreportingsystems,takingpreventiveaction…;(2)topromoteframingofevidence-basedpolicies,includingglobalstandardsthatwillimprovepatientcare,withparticularemphasisonsuchaspectsasproductsafety,safeclinicalpractice…andsafeuseofmedicinalproductsandmedicaldevices,andcreationofacultureofsafetywithinhealthcareorganizations.WorldHealthAssemblyresolution,May2002:QualityofCare:PatientSafety24/12/25Da-YouWang,HuashanHospital5马晓伟副部长部长在2005年4月18日卫生部医院管理年工作会议上的报告•努力提高卫生行政部门管理、统筹、协调医院工作的能力，提高对医院的指导、检查、评价、管理和监督能力。•严防医疗事故，减少医患纠纷，保障医疗安全，提高医疗服务的安全性和有效性。•医务人员不仅在主观上、动机上，还要在客观上、效果上努力维护病人健康，对病人不产生伤害。24/12/25Da-YouWang,HuashanHospital6一、引言合理用药的第一要素是安全，WHO、国家卫生部领导又反复强调医疗安全的重要性，那么目前医疗机构的用药安全情况到底怎么了？24/12/25Da-YouWang,HuashanHospital7引言•事实是近年来药源性损害事件在我国不断上升，有的造成医疗纠纷，有的酿成医疗事故，不但给病人造成损害，对医疗机构亦直接造成经济损失，甚而严重影响了医疗机构的声誉。24/12/25Da-YouWang,HuashanHospital8引言原因何在？1、“安危相易，祸福相生”。药物是“双刃剑”，不仅能治病，也能致病。安全性本身就是相对的；2、实践出真知，人类对药物的认识随着实践而不断深化、不断完善，已有的药物的安全性资料不可能十全十美；3、武器再锐利也要靠人使用，众多新药一涌而入，医务人员仓促上阵，准备不足；24/12/25Da-YouWang,HuashanHospital9引言4、药品的质量标准尚不完备，某些质量低劣的药品有可趁之机；5、我国尚处在社会主义初级阶段，社会发展不平衡，体制不完善。“以药养医”、“以药补医”的体制，致使有些单位只注重药品的商品属性，忽视了药品的治疗属性，将药品与医疗质量的密切相关性抛到了九霄云外。24/12/25Da-YouWang,HuashanHospital...
