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医院患者对其医疗过程中发生的医疗差错和不良事件的报告。

Hospital patients' reports of medical errors and undesirable events in their health care.

机构信息

Research Associate Senior Lecturer Emeritus Professor Clinical Research Fellow Professor of Patient Safety, Imperial College London, Clinical Safety Research Unit, Department of Bio-Surgery and Surgical Technology, St. Mary's Hospital, London, UK.

出版信息

J Eval Clin Pract. 2013 Oct;19(5):875-81. doi: 10.1111/j.1365-2753.2012.01867.x. Epub 2012 Jun 12.

Abstract

OBJECTIVE

To investigate hospital patients' reports of undesirable events in their health care.

DESIGN

Cross-sectional mixed methods design.

PARTICIPANTS

A total of 80 medical and surgical patients (mean age 58, 56 male).

INTERVENTION

Patients were interviewed post-discharge using a survey to assess patient reports of errors or problems in their care. Patients' medical records and notes were also reviewed.

MAIN OUTCOME MEASURES

Frequency of health care process problems, medical complications and interpersonal problems, and patient willingness to report an undesirable event in their care.

RESULTS

In total, 258 undesirable events were reported (rate of 3.2 per person), including 136 interpersonal problems, 90 medical complications and 32 health care process problems. Patients identified a number of events that were reported in the medical records (30 out of 36). In addition, patients reported events that were not recorded in the medical records. Patients were more willing (P < 0.05) to report undesirable events to a researcher (as in the present case) than to a local or national reporting system.

CONCLUSION

Patients appear able to report undesirable events that occur in their health care management over and above those that are recorded in their medical records. However, patients appear more willing to report these incidents for the purpose of a study rather than to an established incident reporting system. Interventions aimed at educating and encouraging patients about incident reporting systems need to be developed in order to enhance this important contribution patients could make to improving patient safety.

摘要

目的

调查医院患者对其医疗保健中不良事件的报告情况。

设计

横断面混合方法设计。

参与者

共 80 名内科和外科患者(平均年龄 58 岁,56 名男性)。

干预措施

患者在出院后接受访谈,使用调查评估患者在护理中报告的错误或问题。还查阅了患者的病历和记录。

主要观察指标

医疗保健过程问题、医疗并发症和人际问题的发生频率,以及患者报告护理中不良事件的意愿。

结果

共报告了 258 起不良事件(每人 3.2 起),包括 136 起人际问题、90 起医疗并发症和 32 起医疗过程问题。患者识别出一些在病历中报告的事件(36 起中的 30 起)。此外,患者还报告了病历中未记录的事件。患者更愿意(P < 0.05)向研究人员(如本案例)报告不良事件,而不是向当地或国家报告系统报告。

结论

患者似乎能够报告其医疗保健管理中发生的不良事件,这些事件超出了病历记录的范围。然而,患者似乎更愿意为研究目的报告这些事件,而不是向既定的事件报告系统报告。需要制定教育和鼓励患者了解事件报告系统的干预措施,以增强患者在提高患者安全性方面做出的重要贡献。

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