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[人为因素与危机资源管理:提高患者安全]

[Human factors and crisis resource management: improving patient safety].

作者信息

Rall M, Oberfrank S

机构信息

InPASS-Institut für Patientensicherheit und Teamtraining GmbH, Friedrich-Naumann-Straße13, 72762, Reutlingen, Deutschland,

出版信息

Unfallchirurg. 2013 Oct;116(10):892-9. doi: 10.1007/s00113-013-2447-5.

DOI:10.1007/s00113-013-2447-5
PMID:24097240
Abstract

A continuing high number of patients suffer harm from medical treatment. In 60-70% of the cases the sources of harm can be attributed to the field of human factors (HFs) and teamwork; nevertheless, those topics are still neither part of medical education nor of basic and advanced training even though it has been known for many years and it has meanwhile also been demonstrated for surgical specialties that training in human factors and teamwork considerably reduces surgical mortality.Besides the medical field, the concept of crisis resource management (CRM) has already proven its worth in many other industries by improving teamwork and reducing errors in the domain of human factors. One of the best ways to learn about CRM and HFs is realistic simulation team training with well-trained instructors in CRM and HF. The educational concept of the HOTT (hand over team training) courses for trauma room training offered by the DGU integrates these elements based on the current state of science. It is time to establish such training for all medical teams in emergency medicine and operative care. Accompanying safety measures, such as the development of a positive culture of safety in every department and the use of effective critical incident reporting systems (CIRs) should be pursued.

摘要

持续有大量患者因医疗治疗而受到伤害。在60%至70%的案例中,伤害来源可归因于人为因素(HFs)和团队协作领域;然而,尽管多年来人们已经知晓,并且同时也已证明,对于外科专业而言,人为因素和团队协作方面的培训可大幅降低手术死亡率,但这些主题仍既未纳入医学教育,也未纳入基础和进阶培训。除了医疗领域,危机资源管理(CRM)的概念已在许多其他行业中通过改善团队协作和减少人为因素领域的失误而证明了其价值。了解CRM和HFs的最佳方法之一是在CRM和HF方面训练有素的教员指导下进行逼真的模拟团队培训。德国创伤外科学会(DGU)提供的用于创伤室培训的HOTT(交接团队培训)课程的教育理念基于当前科学状况整合了这些要素。现在是时候为急诊医学和手术护理中的所有医疗团队开展此类培训了。应推行配套的安全措施,例如在每个科室营造积极的安全文化以及使用有效的危急事件报告系统(CIRs)。

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本文引用的文献

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Temporal trends in rates of patient harm resulting from medical care.医疗导致的患者伤害发生率的时间趋势。
N Engl J Med. 2010 Nov 25;363(22):2124-34. doi: 10.1056/NEJMsa1004404.
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Association between implementation of a medical team training program and surgical mortality.医疗团队培训计划的实施与手术死亡率之间的关系。
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Safety culture and crisis resource management in airway management: general principles to enhance patient safety in critical airway situations.
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[Crew resource management in emergency centers].[急诊中心的医护人员资源管理]
Med Klin Intensivmed Notfmed. 2021 Jun;116(5):377-388. doi: 10.1007/s00063-021-00808-1. Epub 2021 Apr 8.
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Improving patient safety through better teamwork: how effective are different methods of simulation debriefing? Protocol for a pragmatic, prospective and randomised study.通过改善团队协作提高患者安全:不同模拟总结方法的效果如何?一项实用、前瞻性随机研究方案
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