Wednesday, February 7, 2007

防範醫療過失有撇步

Again, 對醫療過程及健康知識的了解lang=EN-US>, 不但在關鍵時刻



可以救自己一命, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>也可能救親朋好友一命!!!





最近在 Albany style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>的華人教會比較大的一個消息就是,



一位只有四十多歲的教授, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>前幾個月被診斷出罹患癌症.



起因是位在腿部的一個腫瘤惡化且癌細胞已經擴散



到肺部了.



他其實六七年前已經有注意到這個腫瘤了lang=EN-US>, 但診斷的



醫師沒有做更進一部的追蹤而錯失了醫療的黃金時期





還有一位很好的朋友的父親, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>在台灣做心導管汽球擴張術



PTCA (Percutaneous
Transluminal Coronary Angioplasty)



失敗而馬上需要做開心手術!





在醫療過程中採取主動積極的態度可能是救命的關鍵lang=EN-US>!!!





不過我想特別說的是, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>我相信大部分的醫療人員都不是



故意也非常不願意讓醫療過失發生lang=EN-US>! 大部分的醫療人員



(尤其是台灣lang=EN-US>) 都非常辛苦, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>我對他們的盡心照顧病人真



的是由衷的敬佩!!!





但是人非聖賢, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>不可能不犯錯, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>尤其在忙碌及勞累的時候



更容易犯錯!!! style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>再者我相信好的醫護人員是一點一滴的



經驗慢慢累積而來的, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>在學習的過程中也很難不犯錯.



但重要的是如何面對錯誤及能即時改正並且防範錯誤



再度發生!!!





所以以下的建議並不是從與醫護人員對立的心態出發lang=EN-US>!!



而是希望大家都能有機會在錯誤發生前就能夠防範lang=EN-US>!!





這些建議, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>大多出自 NYS DOH style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>的網頁,再加上自己的心得,

翻譯部份以綠色字體顯示





style='font-size:14.0pt;color:blue'>Medicines (藥物style='mso-bidi-font-weight:normal'>)



1). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>確定告知你的醫生所有你過去用藥的紀錄style='color:green'>, 如最近服lang=EN-US style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>用過的藥物
(
包含維他命及草藥lang=EN-US style='color:green'>)





2). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>確定告知你的醫生你現在及曾經對哪些藥物有過過敏style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>及副作用





3). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>在領取藥單時先看過一遍確定自己看的懂醫生的筆跡style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>及充分了解藥單的內容style='color:green'>





4). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>在拿到藥單時及領到藥時確定以下事項style='color:green'>:



style='mso-spacerun:yes'> (1). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>每項藥物是做什麼的style='color:green'>? 注意每種藥物的顏色lang=EN-US style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>及外觀!



style='mso-spacerun:yes'> (2). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>如何用藥
(
內用藥lang=EN-US style='color:green'> v.s style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>外用藥);
用藥時間style='color:green'>



lang=EN-US style='color:green'>(用餐前後 style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>或是睡前或是起床後style='color:green'>)



style='mso-spacerun:yes'> (3). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>每項藥物要
(
連續或是間接lang=EN-US style='color:green'>) 服用多久?



style='mso-spacerun:yes'> (4). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>每項藥物可能會有的副作用style='color:green'>; 如果發生副作用lang=EN-US style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>應該如何處理?



style='mso-spacerun:yes'> (5). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>每項藥物對現在正服用的藥物或飲食是否會產生style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>交互作用?



style='mso-spacerun:yes'> (6). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>使用每項藥物應該要注意及避免的事項style='color:green'>





5). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>領藥時確定藥物的種類及計量是醫生所開立的style='color:green'>





6). 如果對用藥有任何的問題馬上提問!! style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>例如: style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>每天服用四次



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>是什麼意思?
是不是指每六小時服用一次lang=EN-US style='color:green'>? 還是應該除去



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>睡眠的時間?





7). 問你的藥劑師如何正確的測量藥物的份量! style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>例如應該用什麼



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>樣的工具測量藥水的計量style='color:green'>?





8). 盡可能要求將用藥應注意的事項 (style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>上面第四項建議中的六項style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>要點) style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>寫在紙上,
尤其是每種藥物可能有的副作用lang=EN-US style='color:green'>





style='font-size:14.0pt;color:blue'>Hospital Stays (住院lang=EN-US style='font-size:14.0pt;color:blue'>)



1). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>盡可能的選擇對所要醫治的疾病最有經驗的醫院及醫師





2). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>詢問及觀察所有接觸你的醫護人員在接觸你前是不是有洗手lang=EN-US style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>及充分消毒醫療器具





3). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>出院前再充分詢問醫護人員回到家在用藥及其它應該注意的事項lang=EN-US style='color:green'>





style='font-size:14.0pt;color:blue'>Surgery (手術style='mso-bidi-font-weight:normal'>)



1) .lang=EN-US style='color:green'> 在手術前, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>確定你,
你的醫生lang=EN-US style='color:green'>, 及你的手術醫生對手術所要做



是事情有一致的看法





2). 手術前lang=EN-US>, 充分詢問醫生及參與手術的醫護人員有關手術的必要性lang=EN-US>.



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>成功/失敗率lang=EN-US>. 所有手術可能導致的副作用及好處lang=EN-US>, 及所有其它可能



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>代替方案的副作用及好處





style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>就我所知, 台灣有許多糖尿病患的截肢是可以避免的



lang=EN-US>(做腿部血管繞道手術) style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>但許多病人並不知道其它的選擇而犧牲



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>了他們寶貴的身體





很多醫院及醫生動不必要的手術是因為手術的報酬比較多





3). 在醫療過程中有問題時一定要隨時詢問lang=EN-US>, 對於重大事項的疑問



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>最好再詢問不同的醫護人員





4). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>確定醫療過程中的責任歸屬style='color:green'>





5). style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>做重要醫療決定時有信任的人在身旁style='color:green'>





6). 對於診斷檢測結果, style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>不要有
no news is good news (
沒有消息就lang=EN-US style='color:green'>



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman";color:green'>是好消息)
的心態lang=EN-US style='color:green'>, 一定要詢問清楚!!!.



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>一則是因為很多的診斷檢測都不是 100% style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>準確的, 還又是因為



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>對診斷檢測結果的解釋會因為人而不同.





7). 知識不僅是力量更可以救命lang=EN-US>, 自己也要做做功課lang=EN-US>,平常就要多多



style='font-family:新細明體;mso-ascii-font-family:"Times New Roman";mso-hansi-font-family:
"Times New Roman"'>注意吸取有關健康及各種疾病的知識





翻譯參考網頁: http://www.health.state.ny.us/nysdoh/healthinfo/20tips.htm





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