Department of Pediatrics, Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
J Perinatol. 2010 Oct;30 Suppl:S51-6. doi: 10.1038/jp.2010.102.
With the introduction of novel technologies and approaches in neonatal care and the lack of appropriately designed and well-executed randomized clinical trials to investigate the impact of these interventions, iatrogenic complications have been increasingly seen in the neonatal intensive care unit. In addition, increased awareness and the introduction of more appropriate quality control measures have resulted in higher levels of suspicion about and increased recognition of complications associated with delivery of care. The incidence of complications also rises with the increased length of hospital stay and level of immaturity. Approximately half of the iatrogenic complications are related to medication errors. The other complications are due to nosocomial infections, insertion of invasive catheters, prolonged mechanical ventilation, administration of parenteral nutrition solution, skin damage and environmental complications. Adopting newer technologies and preventive measures might decrease these complications and improve outcomes. Quality improvement projects targeting areas for improvement are expected to build team spirit and further improve the outcomes. In addition, participation in national reporting systems will enhance education and provide an opportunity to compare outcomes with peer institutions.
随着新生儿护理中新技术和方法的引入，以及缺乏设计合理、执行良好的随机临床试验来研究这些干预措施的影响，医源性并发症在新生儿重症监护病房中日益增多。此外，由于对这些并发症的认识提高，以及更合适的质量控制措施的引入，人们对与提供护理相关的并发症的怀疑程度和识别率也有所提高。并发症的发生率也随着住院时间的延长和不成熟程度的增加而上升。大约一半的医源性并发症与用药错误有关。其他并发症是由于医院感染、插入侵入性导管、长时间机械通气、肠外营养溶液的给予、皮肤损伤和环境并发症引起的。采用更新的技术和预防措施可能会减少这些并发症并改善结果。针对改进领域的质量改进项目预计将建立团队精神，并进一步改善结果。此外，参与国家报告系统将加强教育，并提供与同行机构比较结果的机会。
