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居家患者的不良事件:文献综述。

Adverse events experienced by homecare patients: a scoping review of the literature.

机构信息

Centre for Health Services and Policy Research, Queen's University, Kingston, ONT, Canada.

出版信息

Int J Qual Health Care. 2010 Apr;22(2):115-25. doi: 10.1093/intqhc/mzq003. Epub 2010 Feb 10.


DOI:10.1093/intqhc/mzq003
PMID:20147333
Abstract

PURPOSE: The paper summarizes the results of a scoping review that focused on the occurrence of adverse events experienced by homecare patients. DATA SOURCES: The literature search covered published and grey literature between 1998 and 2007. Databases searched included: MEDLINE, EMBASE, CINAHL and EBM REVIEWS including the Cochrane Library, AGELINE, the National Patient Safety Foundation Bibliography, Agency for Healthcare Research and Quality and the Patient Safety Net bibliography. STUDY SELECTION: Papers included research studies, review articles, policy papers, opinion articles and legal briefs. Inclusion criteria were: (i) homecare directed services provided in the home by healthcare professionals or caregivers; (ii) addressed a characteristic relevant to patient experienced adverse events (e.g. occurrences, rates, definitions, prevention or outcomes); and (iii) were in English. Data extraction A pool of 1007 articles was reduced to 168 after analysis. Data were charted according to six categories: definitions, rates, causes, consequences, interventions and policy. RESULTS: Eight categories emerged: adverse drug events, line-related, technology-related, infections and urinary catheters, wounds, falls, studies reporting multiple rates and other. Reported overall rates of adverse events ranged from 3.5 to 15.1% with higher rates for specific types. Few intervention studies were found. Adverse events were commonly associated with communication problems. Policy suggestions included the need to improve assessments, monitoring, education, coordination and communication. CONCLUSION: A standardized definition of adverse events in the homecare setting is needed. Prospective cohort studies are needed to improve estimates and intervention studies should be undertaken to reduce the risk that homecare patients will experience adverse events.

摘要

目的:本文总结了一项范围综述的结果,该综述重点关注了家庭护理患者所经历的不良事件的发生情况。

资料来源:文献检索涵盖了 1998 年至 2007 年期间发表的和灰色文献。检索的数据库包括:MEDLINE、EMBASE、CINAHL 和 EBM REVIEWS,包括 Cochrane 图书馆、AGELINE、国家患者安全基金会参考书目、美国医疗保健研究与质量局和患者安全网参考书目。

研究选择:纳入的论文包括研究性研究、综述文章、政策文件、观点文章和法律简报。纳入标准为:(i)由医疗保健专业人员或护理人员在家庭中提供的家庭护理定向服务;(ii)针对与患者经历的不良事件相关的特征(例如发生、发生率、定义、预防或结果);(iii)为英文。

数据提取:在分析后,将最初的 1007 篇文章减少到 168 篇。数据根据六个类别进行图表绘制:定义、发生率、原因、后果、干预措施和政策。

结果:出现了八个类别:药物不良事件、与线路相关的、与技术相关的、感染和导尿管、伤口、跌倒、报告多种发生率的研究以及其他。报告的不良事件总发生率从 3.5%到 15.1%不等,特定类型的发生率更高。发现的干预研究很少。不良事件通常与沟通问题有关。政策建议包括需要改进评估、监测、教育、协调和沟通。

结论:需要在家庭护理环境中制定不良事件的标准化定义。需要前瞻性队列研究来提高估计值,并应进行干预研究,以降低家庭护理患者经历不良事件的风险。

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