每年都有非常多没辜的人死于医院的系统漏洞
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">源自</span> | 公众号“陈净<span style="color: black;">医生</span>”</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;">据述</span>每年，<span style="color: black;">因为</span>医院的系统性漏洞<span style="color: black;">引起</span>死亡的人数非常多。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">我就从今天病房<span style="color: black;">出现</span>的一件小事，<span style="color: black;">来讲</span>说医院有多少漏洞。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">我有个病人糖尿病<span style="color: black;">无</span>好好<span style="color: black;">掌控</span>，药<span style="color: black;">亦</span>不吃，胰岛素<span style="color: black;">亦</span>不打，<span style="color: black;">引起</span>糖尿病足溃烂截肢。住院以后，从<span style="color: black;">大夫</span>到营养师到糖尿病教育专员，轮番教育了他一番，让他<span style="color: black;">必定</span>要好好按时吃药。<span style="color: black;">咱们</span>给他新<span style="color: black;">增多</span>了二甲双胍。二甲双胍的<span style="color: black;">重点</span>副<span style="color: black;">功效</span>是胃肠道副反应，<span style="color: black;">因此</span>在加药以后<span style="color: black;">必须</span>观察有<span style="color: black;">无</span>副<span style="color: black;">功效</span>。这个药吃了以后，病人的血糖<span style="color: black;">掌控</span>的很不错，<span style="color: black;">亦</span><span style="color: black;">无</span>什么胃肠道副反应，于是准备择日出院了。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;">倘若</span>一切顺利，其实就啥事<span style="color: black;">亦</span><span style="color: black;">无</span>了。<span style="color: black;">然则</span>病人一听到要出院，就高兴的放开肚皮吃<span style="color: black;">各样</span>汉堡。于是血糖飙升，在出院前一天，<span style="color: black;">因为</span>血糖太高，二甲双胍的量<span style="color: black;">增多</span>了1倍，从500mg变<span style="color: black;">成为了</span>1000mg。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">大<span style="color: black;">都数</span><span style="color: black;">状况</span>下，1000mg的二甲双胍病人<span style="color: black;">亦</span>会耐受的很好，<span style="color: black;">通常</span>不会<span style="color: black;">显现</span>什么副反应。<span style="color: black;">然则</span>偏偏在出院当天，病人跟我说吃了二甲双胍以后，<span style="color: black;">显现</span>了恶心、呕吐等胃肠道反应。于是二甲双胍在出院当天从1000mg减到500mg。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q5.itc.cn/q_70/images03/20240423/20ec2e5d946746ec854b52260e8e4789.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">这个医院的常规是，出院前一天，把出院要带的药都要开处方准备好。<span style="color: black;">因此</span>病人的药是<span style="color: black;">根据</span>每顿1000mg来准备的。出院当天，我临时把1000mg减到500mg了。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，<span style="color: black;">倘若</span>只是<span style="color: black;">药品</span>剂量减半，其实<span style="color: black;">亦</span>没什么，就告诉病人剂量减半，<span style="color: black;">例如</span>说原来吃一片，<span style="color: black;">此刻</span>吃半片，就好了。<span style="color: black;">然则</span>好巧不巧，<span style="color: black;">药店</span><span style="color: black;">发掘</span>，二甲双胍有1000mg一片和500mg一片的。原来是<span style="color: black;">根据</span>1000mg一片来准备的，<span style="color: black;">此刻</span>减<span style="color: black;">成为了</span>500mg，把1000mg一片的掰成两半有点不方便，于是说要改成500mg一片的。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q9.itc.cn/q_70/images03/20240423/a5fd7dd5c2034fb3ae690ec7c15eeabb.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，同种<span style="color: black;">药品</span>不同剂型，在大<span style="color: black;">都数</span><span style="color: black;">药店</span>，药剂师都<span style="color: black;">能够</span>自己做决定。没想到在这个医院，<span style="color: black;">药品</span>的<span style="color: black;">详细</span>一片多少量的剂型，药剂师都<span style="color: black;">不可</span>擅自做主，<span style="color: black;">必须</span><span style="color: black;">大夫</span>改处方。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">改就改吧，于是我就从1000mg一片改<span style="color: black;">成为了</span>500mg一片的。<span style="color: black;">那样</span>一改，<span style="color: black;">药店</span>又要重新准备药。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，重新准备<span style="color: black;">亦</span>花不了几分钟。<span style="color: black;">然则</span>好巧不巧，药剂师<span style="color: black;">没</span>端端又发短信问了我一句：<span style="color: black;">为何</span>病人从每顿1000mg减到500mg了？其实我在病历里写的清清楚楚，<span style="color: black;">由于</span>病人<span style="color: black;">显现</span>了消化道反应，才减了量。<span style="color: black;">然则</span>药剂师<span style="color: black;">无</span>看病历，<span style="color: black;">况且</span>还在<span style="color: black;">始终</span>在等我的回复，<span style="color: black;">无</span>回复她就不出药。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，我都会看我的手机，<span style="color: black;">即时</span>回复医院的短信。<span style="color: black;">然则</span>好巧不巧，我当时有一个病情非常重的病人<span style="color: black;">必须</span>联系多科会诊，等我打完一通<span style="color: black;">tel</span>再看短信，<span style="color: black;">已然</span>是一个小时以后了。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;">一般</span><span style="color: black;">状况</span>下<span style="color: black;">亦</span>没事，<span style="color: black;">由于</span>病人都是要等药剂师发完药、护士领完药回来以后跟病人核对，<span style="color: black;">才可</span>让病人出院离开病房。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;">然则</span>好巧不巧，当天负责的护士有点糊涂，<span style="color: black;">亦</span>有点懒惰，不愿意跑腿帮病人去<span style="color: black;">药店</span>领药，而是让病人自己直接去<span style="color: black;">药店</span>领药。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，<span style="color: black;">倘若</span>药剂师跟病人说一句，让他等二甲双胍，病人应该不会拒绝。<span style="color: black;">然则</span>好巧不巧，病人去到<span style="color: black;">药店</span>，药剂师把除了二甲双胍以外的其他的药都交给病人了，<span style="color: black;">亦</span><span style="color: black;">无</span>跟病人说，还差一味药。病人就以为所有的药都给他了，于是从<span style="color: black;">药店</span>领完药，他<span style="color: black;">亦</span>没回病房跟护士核对，就直接出院了。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">等我忙完看到短信、回复药剂师、药剂师配好药，再找病人，<span style="color: black;">发掘</span>病人<span style="color: black;">已然</span>不在病房了。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，病人在电子病历系统Epic里面都留有联系方式，病人出院了<span style="color: black;">亦</span><span style="color: black;">能够</span><span style="color: black;">经过</span><span style="color: black;">tel</span>联系他来病房领药。<span style="color: black;">然则</span>好巧不巧，病人在Epic里面留了假的联系方式。<span style="color: black;">由于</span>他多次不听医嘱擅自出院，为了不让医院轻易找到他，就<span style="color: black;">无</span>留真实的联系方式。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">于是一个糖尿病病人，在住院以后被医护人员三番五次教育要好好吃药的<span style="color: black;">状况</span>下，竟<span style="color: black;">由于</span>医院<span style="color: black;">全部</span>系统的种种漏洞，<span style="color: black;">无</span>拿到糖尿病的药，就出院了。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，Epic系统里面的<span style="color: black;">tel</span>是<span style="color: black;">必须</span>病例管理人员进一步核实的，<span style="color: black;">然则</span>种种<span style="color: black;">原由</span>，在他住院的<span style="color: black;">那样</span>多天里，病例管理人员都<span style="color: black;">无</span>去核实他的联系方式。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">那<span style="color: black;">无</span>联系方式怎么办呢？</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">我看到他还有个家庭住址，<span style="color: black;">亦</span>不确定是不是真实的<span style="color: black;">位置</span>，想着实在不行就下班顺路给他送药过去了。<span style="color: black;">忽然</span>灵机一动，用我在霍普金斯的Epic来搜，找到了这个病人的病历资料，<span style="color: black;">而后</span>一页一页的翻，<span style="color: black;">最终</span>从某年某月的老黄历里找到了他真实的联系<span style="color: black;">tel</span>。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">我给他打<span style="color: black;">tel</span>过去，把他吓一跳，他没想到留了个假<span style="color: black;">tel</span>医院都能找到他。跟他说了他的药没拿，他感激涕零，说要回来拿药。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">正常<span style="color: black;">状况</span>下，他回来拿药就啥事<span style="color: black;">无</span>了。<span style="color: black;">然则</span>别忘了他是下肢截肢的，他自己一个人开车回来拿药，单腿<span style="color: black;">没</span>法<span style="color: black;">落车</span>进医院，只能停车在医院，<span style="color: black;">而后</span>还得找个人给他送到停车场。（为啥单腿还能开车？这个肯定是不合法的，只是在车上警察估计<span style="color: black;">亦</span>看不到他是一条腿还是两条腿，就<span style="color: black;">那样</span>糊弄过关了）。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">我联系好<span style="color: black;">药店</span>，让<span style="color: black;">药店</span>找个人，在他回来以后，给他送药送到停车场。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><span style="color: black;">倘若</span>一切正常，<span style="color: black;">药店</span>有个专门跑腿的，<span style="color: black;">然则</span>好巧不巧，今天那个跑腿的辞职了。于是药剂师说她会自己送过去。才算<span style="color: black;">处理</span>了这个问题。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">感慨一下：这个医院的设置系统漏洞太多了！就像是瑞士奶酪的<span style="color: black;">各样</span>洞洞，事故的<span style="color: black;">出现</span><span style="color: black;">必定</span>是一层一层疏漏累积的结果。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q4.itc.cn/q_70/images03/20240423/9058eb2b56304fdaa98a5a44db03326c.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">而一个好的医院系统，就要设置足够的安全屏障，即便在<span style="color: black;">各样</span>人为<span style="color: black;">原因</span>，人为过失的漏洞下，都<span style="color: black;">没</span>法击穿，<span style="color: black;">才可</span>叫好的医疗系统。</span></span><a style="color: black;"><span style="color: black;">返回<span style="color: black;">外链论坛：http://www.fok120.com/</span>，查看<span style="color: black;">更加多</span></span></a></p>
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感谢你的精彩评论，带给我新的思考角度。 你的见解独到，让我受益匪浅，非常感谢。
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