New York Medical College, Westchester Medical Center, Valhalla, 10595, USA.
Clin J Am Soc Nephrol. 2012 Apr;7(4):680-8. doi: 10.2215/CJN.06530711. Epub 2012 Jan 26.
Patient safety is the foundation of high-quality health care. More than 350,000 patients receive dialysis in the United States, and the safety of their care is ultimately the responsibility of the facility medical director. The medical director must establish a culture of safety in the dialysis unit and lead the quality assessment and performance improvement process. Several lines of investigation, including surveys of patients and dialysis professionals, have helped to identify important areas of safety risk in dialysis facilities. Among these are lapses in communication, medication errors, patient falls, errors in machine and membrane preparation, failure to follow established policies, and lapses in infection control. The quality assessment and performance improvement process should include a dedicated safety team to focus on specifically identified areas of risk and to establish outcome goals guided by best practices and agreed-upon measures of success. A safety questionnaire can be given to patients and staff and the responses evaluated to improve understanding of the prevailing attitudes and concerns about safety. By sharing these results, openly acknowledging the challenges, and using a blame-free root cause process to identify action plans, the facility can begin to establish a culture of safety.
患者安全是高质量医疗保健的基础。在美国，有超过 35 万名患者接受透析治疗，而他们的护理安全最终是医疗机构医疗主任的责任。医疗主任必须在透析单位建立安全文化，并领导质量评估和绩效改进过程。包括对患者和透析专业人员进行调查在内的几条调查线索，有助于确定透析设施中的重要安全风险领域。这些领域包括沟通失误、用药错误、患者跌倒、机器和膜准备错误、未能遵守既定政策以及感染控制失误。质量评估和绩效改进过程应包括一个专门的安全小组，专注于具体确定的风险领域，并根据最佳实践和商定的成功衡量标准制定成果目标。可以向患者和员工发放安全问卷，并对其答复进行评估，以提高对安全方面现有态度和关注的理解。通过分享这些结果、公开承认挑战，并使用无责根源分析过程来确定行动计划，该设施可以开始建立安全文化。
