Killip Shersten, Ireson Carol L, Love Margaret M, Fleming Steven T, Katirai Whitney, Sandford Katherine
Department of Family and Community Medicine, University of Kentucky, K302 Kentucky Clinic 0284, 740 S. Limestone, Lexington, KY 40536-0284, USA.
Fam Med. 2007 Jun;39(6):404-9.
This study analyzed our family medicine department's after-hours telephone medicine systems at an academic health center from a patient safety perspective. The research questions were (1) What are the threats to patient safety associated with after-hours telephone medicine and (2) What kinds of errors are made during after-hours telephone medicine?
Subjects were patients at the University of Kentucky family medicine practice who called in to the after-hours answering service. Telephone interviews were conducted with 64 patients over 10 weeks. During the interviews, patients described their telephone medicine experience, identified any problems, and reported potential or actual harm (patient-identified threats to patient safety). Two registered nurses and one physician analyzed the patient narratives to identify threats to patient safety (medical personnel-identified threats to patient safety).
Sixty-three analyzable patient interviews identified four instances (6%) of temporary physical harm. Two separate after-hours calls (3%) involved four medical errors with potentially serious consequences to patient safety (wrong dose, serious illness not ruled out). Fourteen calls (22%) involved events that could have threatened patient safety.
Situations that threaten patient safety occur frequently in telephone medicine. Although this study is too small to draw strong conclusions, it suggests that there are risks to patient safety associated with after-hours telephone medicine.
本研究从患者安全的角度分析了一家学术医疗中心家庭医学科的非工作时间电话医疗系统。研究问题为：（1）与非工作时间电话医疗相关的患者安全威胁有哪些？（2）非工作时间电话医疗期间会出现哪些类型的错误？
研究对象为肯塔基大学家庭医学诊所致电非工作时间应答服务的患者。在10周内对64名患者进行了电话访谈。访谈期间，患者描述了他们的电话医疗经历，指出了任何问题，并报告了潜在或实际的伤害（患者识别出的对患者安全的威胁）。两名注册护士和一名医生分析了患者的叙述，以识别对患者安全的威胁（医务人员识别出的对患者安全的威胁）。
63次可分析的患者访谈发现了4例（6%）暂时身体伤害情况。两次不同的非工作时间来电（3%）涉及4起对患者安全可能产生严重后果的医疗错误（剂量错误、未排除重病）。14次来电（22%）涉及可能威胁患者安全的事件。
在电话医疗中，威胁患者安全的情况经常发生。尽管本研究规模太小，无法得出有力结论，但它表明非工作时间电话医疗存在患者安全风险。
