Eschmann D, Schüttpelz-Brauns K, Obertacke U, Schreiner U
Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland.
Unfallchirurg. 2013 Oct;116(10):884-91. doi: 10.1007/s00113-013-2446-6.
Patient safety in hospitals is difficult to define and is not measurable by operational safety parameters as in other fields. So-called adverse events (AE) are a collective of complications, failures, mistakes, errors and violations. Estimations of at least 9.2 % AEs in surgery with 0.1 % fatalities are given worldwide but there are no correlations between objective quantification of AEs and subjective or public perception of safety during the perioperative period. Patient safety during this period is mostly endangered by wound infections (safety 98 %) and nosocomial infections (safety 97 %). In spite of these facts, safety parameters for problems in anesthesia, blood transfusion, in retaining surgical instruments and so-called index events, such as patient and side identification errors are much higher. Patient safety is maintained in hospitals by objective means (surgical). Checklists have been proven to improve safety and critical incidence reporting, training and changing of attitudes could have further advantages but they are difficult to measure.
医院中的患者安全难以定义，也无法像其他领域那样通过操作安全参数来衡量。所谓的不良事件（AE）是并发症、故障、失误、错误和违规行为的统称。全球范围内，手术中不良事件发生率估计至少为9.2%，其中死亡率为0.1%，但围手术期不良事件的客观量化与主观或公众对安全的认知之间并无关联。在此期间，患者安全主要受到伤口感染（安全率98%）和医院感染（安全率97%）的威胁。尽管如此，麻醉、输血、手术器械留存以及所谓的索引事件（如患者和部位识别错误）等问题的安全参数要高得多。医院通过客观手段（手术）来维护患者安全。检查表已被证明可提高安全性，而关键事件报告、培训和态度转变可能会带来更多益处，但这些都难以衡量。
