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[IBEAS设计:拉丁美洲医院的不良事件发生率]

[IBEAS design: adverse events prevalence in Latin American hospitals].

作者信息

Aranaz-Andrés J M, Aibar-Remón C, Limón-Ramírez R, Amarilla A, Restrepo F R, Urroz O, Sarabia O, Inga R, Santivañez A, Gonseth-García J, Larizgoitia-Jauregui I, Agra-Varela Y, Terol-García E

机构信息

Servicio de Medicina Preventiva y Calidad Asistencial, Hospital Universitari Sant Joan d'Alacant, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández, Elche, Alicante, España. aranaz

出版信息

Rev Calid Asist. 2011 May-Jun;26(3):194-200. doi: 10.1016/j.cali.2010.12.001. Epub 2011 Apr 2.

Abstract

OBJECTIVES

To describe the methodological characteristics of the IBEAS study: adverse events prevalence in Latin American hospitals, with the aim of analysing the magnitude, significance and impact of adverse events (AE); to identify the main problems associated with patient safety AE; to increase the capacity of professionals involved in patient safety; and the setting up of patient safety agendas in the participating countries.

METHODS

A patient safety study launched in 35 Latin American hospitals through the analysis of AE in 5 countries: Argentina, Colombia, Costa Rica, Mexico and Peru, using a cross-sectional study using a review of clinical records as the main method.

RESULTS

The implications of using a cross-sectional design when studying AE are described, in terms of resources required, internal validity and usefulness related to risk management.

CONCLUSIONS

The cross-sectional design seems an efficient methodology in terms of time and resources spent, as well as being easy to carry out. Although the cross-sectional design does not review the all hospital episodes, it is able to provide a reliable estimate of prevalence and to support a surveillance system. Because of a possible survival bias, it is likely that the AE which led to hospital admissions will be overestimated, as well as the health related infections or those adverse events which are difficult to identify if the patient is not examined (e.g. contusions). Communication with the ward staff (if the patient is still hospitalised) help in finding the causality and their prevention.

摘要

目标

描述IBEAS研究的方法学特征:拉丁美洲医院的不良事件发生率,旨在分析不良事件(AE)的严重程度、重要性和影响;识别与患者安全不良事件相关的主要问题;提高参与患者安全工作的专业人员的能力;以及在参与国建立患者安全议程。

方法

通过对阿根廷、哥伦比亚、哥斯达黎加、墨西哥和秘鲁5个国家的35家拉丁美洲医院的不良事件进行分析,开展一项患者安全研究,采用横断面研究,以临床记录回顾作为主要方法。

结果

描述了在研究不良事件时使用横断面设计的影响,包括所需资源、内部效度以及与风险管理相关的实用性。

结论

就所花费的时间和资源而言,横断面设计似乎是一种有效的方法,并且易于实施。虽然横断面设计并未审查所有医院事件,但它能够提供患病率的可靠估计,并支持监测系统。由于可能存在生存偏差,导致住院的不良事件以及与健康相关的感染或那些如果不检查患者就难以识别的不良事件(如挫伤)可能会被高估。与病房工作人员沟通(如果患者仍住院)有助于查明因果关系及其预防。

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