Casey Michelle M, Wakefield Mary, Coburn Andrew F, Moscovice Ira S, Loux Stephenie
Rural Health Research Center, University of Minnesota, Minneapolis, USA.
Jt Comm J Qual Patient Saf. 2006 Dec;32(12):693-702. doi: 10.1016/s1553-7250(06)32092-2.
A study was conducted in 2004 to determine if 26 interventions--distributed among nine patient safety areas and as recommended by an expert panel as relevant to rural hospitals--would be validated in terms of relevance and implementability for small and rural facilities.
The chief executive officers (CEOs) and/or key managers responsible for patient safety activities in a diverse group of 29 small and rural hospitals assessed the potential effectiveness and feasibility of the 26 interventions. Representatives of 25 hospitals participated in structured, follow-up phone discussions.
Adverse drug events were the highest-priority area for 14 hospitals, followed by patient falls (selected by 5 hospitals). Some hospitals had already implemented intervention 1 (use at least two patient identifiers) and intervention 6 (read back of verbal orders) and thus ranked them highly, especially for implementability. Intervention 3 (24-hour pharmacist coverage) was ranked low, especially on implementability. Interventions involving health information technology were ranked lower by the hospitals than by the expert panel.
Safety interventions should reflect the general state of the science of safe practices while incorporating relevant contextual issues unique to rural hospitals. The results have important implications for survey and accreditation activity, and the focus of technical assistance and research efforts.
2004年开展了一项研究，以确定26项干预措施（分布在九个患者安全领域，由一个专家小组推荐，与农村医院相关）在小型和农村医疗机构中的相关性和可实施性方面是否得到验证。
29家小型和农村医院的首席执行官（CEO）和/或负责患者安全活动的关键管理人员评估了这26项干预措施的潜在有效性和可行性。25家医院的代表参加了结构化的后续电话讨论。
药品不良事件是14家医院的首要关注领域，其次是患者跌倒（5家医院选择）。一些医院已经实施了干预措施1（使用至少两种患者识别码）和干预措施6（口头医嘱复述），因此对它们的评价很高，尤其是在可实施性方面。干预措施3（24小时药剂师值班）排名较低，尤其是在可实施性方面。医院对涉及卫生信息技术的干预措施的排名低于专家小组。
安全干预措施应反映安全实践科学的总体状况，同时纳入农村医院特有的相关背景问题。研究结果对调查和认证活动以及技术援助和研究工作的重点具有重要意义。
