Schwoebel Ann, Creely Janet
Intensive Care Nursery, Pennsylvania Hospital, Philadelphia, PA 19107, USA.
J Perinat Neonatal Nurs. 2010 Jan-Mar;24(1):81-7. doi: 10.1097/JPN.0b013e3181ce33ab.
Patient safety is one of the greatest imperatives in healthcare today, yet there are many obstacles that must be overcome to make healthcare delivery truly safe. Critically ill newborns are among the most medically fragile patients in hospitals today. Given their size and gestational age, the tolerance for error within this population is extremely small. Medical errors that may be less consequential in adults can be disastrous for infants. Developing a culture of safety demands a mind-set that continuously seeks out vulnerabilities and prospectively addresses them through systems-based rather than individual-based solutions. The complexities of clinical care and intricacies of human behavior may prevent total elimination of risk, but caregivers are in a position to develop a culture of safety that can minimize risks for adverse events in the neonatal intensive care unit. Specific strategies used to successfully implement a staff-focused patient safety program are described in this article. These strategies include the development of systemwide and unit-based interdisciplinary safety teams to proactively identify and address safety concerns, development of specific tools and techniques used for analysis and prioritization of risk, resources that teams used to support an environment of safety; and implementation of staff-driven solutions to address safety concerns.
患者安全是当今医疗保健领域最紧迫的要求之一，但要使医疗服务真正安全，仍有许多障碍必须克服。危重新生儿是当今医院中医疗状况最脆弱的患者群体之一。鉴于他们的体型和孕周，这一群体对差错的容忍度极低。在成人身上可能后果较轻的医疗差错，对婴儿来说可能是灾难性的。营造安全文化需要一种思维模式，即不断寻找薄弱环节，并通过基于系统而非基于个人的解决方案前瞻性地加以解决。临床护理的复杂性和人类行为的错综复杂可能会阻碍风险的完全消除，但护理人员有能力营造一种安全文化，将新生儿重症监护病房不良事件的风险降至最低。本文介绍了成功实施以员工为重点的患者安全计划所采用的具体策略。这些策略包括组建全系统和基于科室的跨学科安全团队，以主动识别和解决安全问题；开发用于风险分析和优先级排序的特定工具和技术；团队用于支持安全环境的资源；以及实施由员工推动的解决方案来解决安全问题。
