School of Nursing, Deakin University, 221 Burwood Hwy, Burwood, Victoria, Australia.
Emerg Med J. 2011 May;28(5):416-21. doi: 10.1136/emj.2010.093054. Epub 2010 Jul 26.
The aim of this study was to examine reported incidents affecting Emergency Department (ED) episodes of care.
A retrospective audit of ED patients was carried out in an urban district hospital in Melbourne, Australia from 1 January 2008 to 31 December 2008. The main outcome measure was presence or absence of reported patient-related incident(s) during ED care.
There were 984 patient-related incidents (n=984) during 2008.The most common incidents were related to patient behaviour (66.4%), patient management (10.1%) and medications (6.5%). Patients whose ED care involved reported incident(s) were older, had higher triage categories, longer length of ED stay and were more likely to need hospital admission or leave at their own risk. Eighteen per cent of reported incidents occurred in patients aged 65 years and over. Incidents affecting older patients were more likely to be related to breach of skin integrity, patient management, diagnosis and patient identification, and less likely to involve patient behaviour.
Reported incident(s) occurred in 0.47% of ED episodes of care. Differences in personal and clinical characteristics of patients whose ED care involved reported incident(s) highlights the need for better understanding of incidents occurring in the ED in order to improve systems for high-risk patients.
本研究旨在调查影响急诊（ED）治疗过程的报告事件。
2008 年 1 月 1 日至 12 月 31 日，在澳大利亚墨尔本的一家城区医院对 ED 患者进行了回顾性审核。主要观察指标为 ED 治疗过程中是否存在报告的患者相关事件。
2008 年共发生 984 起与患者相关的事件（n=984）。最常见的事件与患者行为（66.4%）、患者管理（10.1%）和药物（6.5%）有关。ED 治疗中涉及报告事件的患者年龄较大，分诊级别较高，ED 停留时间较长，更有可能需要住院治疗或自行出院。18%的报告事件发生在 65 岁及以上的患者中。影响老年患者的事件更有可能与皮肤完整性受损、患者管理、诊断和患者身份识别有关，而不太可能涉及患者行为。
报告事件占 ED 治疗过程的 0.47%。ED 治疗中涉及报告事件的患者在个人和临床特征方面存在差异，这突显了需要更好地了解 ED 中发生的事件，以便改进针对高风险患者的系统。
