Swiss Patient Safety Foundation, Zuerich, Switzerland.
Swiss Med Wkly. 2012 Jun 6;142:w13601. doi: 10.4414/smw.2012.13601. eCollection 2012.
Little is known about primary care professionals' concerns about risks to patient safety.
To identify threats to patient safety in the primary care office from the perspective of physicians and nurses.
Cross-sectional survey; participants were asked to name and rank threats to safety they personally were most concerned about.
Physicians and nurses working in primary care offices in Switzerland.
Verbatim reports were analysed under an inductive content-analysis framework. Coded threats were quantitatively analysed in terms of frequency and prioritisation. Differences between physicians and nurses were analysed.
Of 1260 invited individuals, 630 responded to the survey and 391 (31%) described 936 threats to patient safety. The coding system included 29 categories organised in 5 themes. Agreement of coders was good (kappa = 0.87, CI = 0.86-0.87). Safety of medication (8.8%), triage by nurses (7.2%) and drug interactions (6.8%) were the threats cited most frequently. Errors in diagnosis (OR = 0.21, CI 0.09-0.47, p <0.001), drug interactions (OR = 0.10, CI 0.04-0.25, p <0.001) and compliance of patients (OR = 0.28, CI 0.08-0.96, p = 0.044) were more likely to be cited by physicians. X-rays (OR = 3.34, CI 1.04-10.71, p = 0.043), confusion of patients or records (OR = 3.28, CI 1.55-6.94, p = 0.002), hygiene (OR = 3.21, CI1.12-9.19, p = 0.030), safety of office rooms (OR = 6.70, CI 1.46-30.73, p = 0.014), and confidentiality (OR = 7.38, CI 1.63-33.50, p = 0.010) were more likely to be described by nurses.
Physicians and nurses are concerned about diverse threats to patient safety in primary care. Involving both groups in detection and analysis of risks in medical offices seems a valuable strategy to improve collaboration and safety.
对于初级保健专业人员对患者安全风险的担忧，我们知之甚少。
从医生和护士的角度确定初级保健办公室的患者安全威胁。
横断面调查；参与者被要求说出并排名他们个人最担心的安全威胁。
瑞士初级保健办公室的医生和护士。
根据归纳内容分析框架分析逐字报告。根据频率和优先级对编码威胁进行定量分析。分析医生和护士之间的差异。
在 1260 名受邀者中，有 630 人对调查做出了回应，其中 391 人（31%）描述了 936 种对患者安全的威胁。编码系统包括 29 个类别，分为 5 个主题。编码员之间的一致性很好（kappa = 0.87，CI = 0.86-0.87）。药物安全（8.8%）、护士分诊（7.2%）和药物相互作用（6.8%）是最常被提及的威胁。诊断错误（OR = 0.21，CI 0.09-0.47，p <0.001）、药物相互作用（OR = 0.10，CI 0.04-0.25，p <0.001）和患者依从性（OR = 0.28，CI 0.08-0.96，p = 0.044）更有可能被医生提及。X 射线（OR = 3.34，CI 1.04-10.71，p = 0.043）、患者或记录混淆（OR = 3.28，CI 1.55-6.94，p = 0.002）、卫生（OR = 3.21，CI1.12-9.19，p = 0.030）、办公区安全（OR = 6.70，CI 1.46-30.73，p = 0.014）和保密性（OR = 7.38，CI 1.63-33.50，p = 0.010）更有可能被护士描述。
医生和护士都对初级保健中患者安全的各种威胁感到担忧。让这两个群体都参与到医疗办公室风险的检测和分析中，似乎是改善协作和安全性的一项有价值的策略。
