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MOC-PS(SM) 继续医学教育文章:门诊环境中的患者安全

MOC-PS(SM) CME article: patient safety in the office-based setting.

作者信息

Horton J Bauer, Janis Jeffrey E, Rohrich Rod J

机构信息

Dallas, Texas From the Department of Plastic Surgery, Nancy L & Perry Bass Advanced Wound Healing Laboratory, University of Texas Southwestern Medical Center.

出版信息

Plast Reconstr Surg. 2008 Sep;122(3 Suppl):1-21. doi: 10.1097/PRS.0b013e318183c118.

Abstract

LEARNING OBJECTIVES

After studying this article, the participant should be able to: 1. Discern the importance of the physician's office administrative structure. 2. Recognize the necessity of a system for quality assessment. 3. Assess which procedures are safe in the office-based setting. 4. Know the basic steps for properly evaluating patients for office-based plastic surgery.

SUMMARY

This article reviews the literature on office-based patient safety issues. It places special emphasis on the statements and advisories published by the American Society of Plastic Surgeons' Convened Task Force on Patient Safety in the Office-Based Setting. The article divides patient safety in the health care delivery system into four broad categories. First, patient safety starts with emphasis at the administrative level. The physician or independent governing body must develop a system of quality assessment that functions to minimize preventable errors and report outcomes and errors. Second, the clinical aspects of patient safety require that the physician evaluate whether the procedure(s) and the patient are proper for the office setting. Third, this article gives special attention to liposuction, the most frequently performed office-based plastic surgery procedure. Finally, the article reviews the management of postoperative pain, nausea, and vomiting. Patient safety must be every physician's highest priority, as reflected in the Hippocratic Oath: primum non nocere ("first, do no harm").

摘要

学习目标

在学习本文后,参与者应能够:1. 识别医师办公室行政结构的重要性。2. 认识到质量评估系统的必要性。3. 评估哪些程序在门诊环境中是安全的。4. 了解对门诊整形手术患者进行正确评估的基本步骤。

总结

本文回顾了关于门诊患者安全问题的文献。它特别强调了美国整形外科医师协会召集的门诊患者安全特别工作组发表的声明和建议。本文将医疗保健提供系统中的患者安全分为四大类。首先,患者安全始于行政层面的重视。医师或独立管理机构必须建立一个质量评估系统,其作用是尽量减少可预防的错误,并报告结果和错误。其次,患者安全的临床方面要求医师评估该程序和患者是否适合门诊环境。第三,本文特别关注抽脂术,这是最常进行的门诊整形手术。最后,本文回顾了术后疼痛、恶心和呕吐的管理。患者安全必须是每位医师的首要任务,正如希波克拉底誓言所体现的:首要的是不伤害(“首先,不要造成伤害”)。

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