自2004年建置「台灣病人安全通報系統」至今，統計2005年～2011年間的異常事件歷史資料，藥物事件佔58977件，總件數最多。病人安全是醫療服務的核心價值，捍衛病人安全必先鞏固用藥安全，藥師負責的調劑作業是守護用藥安全的關鍵。本研究針對視覺相關議題進行研究，藉由眼動儀記錄藥師執行調配作業時的視覺歷程，並透過客觀眼動資料及個別訪談內容進行分析，探討藥名呈現方式等對藥師執行調配作業時視覺行為的影響，進而找出影響藥品辨識的相關因子，提高調劑作業品質與用藥安全。
研究方法使用實驗法，選定實地情境，舉凡受試者、自變數、作業任務、環境條件皆來自實務狀況。本研究以醫院藥師為實驗受試者，受試者由三家醫院招募，共30人，自變數為藥袋藥物資訊順序配置（藥名優先、劑量優先、劑型優先），應變數為視覺行為資料與受試者訪談資料，視覺行為資料包含凝視點、平均凝視時間及視覺軌跡。
調配實驗的結果發現，醫院藥袋藥名英文字母全部以大寫方式呈現的受試者，其凝視點平均凝視時間較長。比較不同排列次序藥名所產生的眼動數據，發現警示訊息在前的藥名資訊眼動值有較大的趨勢，其所產生的凝視點數也顯著多於藥名在前的藥名資訊。橫向文字的閱讀方向通常是由左至右，但是在高度時間壓力下，讀取由多個子訊息組合而成的資訊時，很可能受個人經驗或偏好而產生選擇性閱讀的情況。若將受試者分為資深及資淺藥師，發現不同單位年資受試者在藥袋停留時間比例（訊息處理過程中，接收訊息所佔比例）具有顯著差異，在視覺行為上資深藥師具有較多回視、裝袋前核對的現象，願意花費較多的時間確保用藥安全。

According to Taiwan Patient Safety Reporting System established since 2004, the most of abnormal events during the period of years from 2005 to 2011 was about medication issue and totally 58977. It is without saying that patient safety is the core value of medical service. It was known that before defensing patient safety it is necessary to consolidate medication safety. Hence, the dispensing process operated by pharmacists is the critical point to maintain medication safety.
The researches linked to visual scanning during the dispensing tasks are relatively rare. It is a primary requirement to collect related behavior data for being the researching foundation if we dedicate to prevent radically identification errors resulted from human factors. For this reason, the research issue of this study is focused on eye movements under dispensing process which are recorded objectively by an eye tracker. Besides, the research is also combined with the subjective method to interview participants for exploring how the medicine's name indication influence a pharmacist’s visual behaviors while processing dispensing tasks. It is expected to find out the related human factors and improve dispensing quality and medication safety.
The present study is to apply experimental method based on field setting. All of participants, independent variables, dispensing tasks and operating environments are set with reality. Thirty pharmacists who all serve in hospital and come from different hospitals participate in this experiment. The independent variable is the information layout on medicine bag arranged with medicine name, dose or alert message. In addition, dependent variables are about visual behaviors and participants’ interview contents. Visual behaviors include fixations, average fixation duration and visual tracks.
The results indicate that medicine name all use capital letters of the alphabet presented subjects whose average fixation duration longer. The results also shown that different layout of medicine name affect number of fixations and eye movement data, the previous of alert messages have a greater tendency. The transverse direction is normally read text from left to right, but high stress and time pressure, a combination of a plurality of sub information is read from the message, it is likely to be a personal experience or preference to selective reading situation. If subjects were divided into senior and junior pharmacists, found that different seniority viewing percent time spent in zone with statistically significant differences. On the visual behavior of senior pharmacists have more regressions and check before bagging, are willing to spend more time ensuring medication safety.

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