Doran Diane M, Baker G Ross, Szabo Cathy, McShane Julie, Carryer Jennifer
Nursing Health Services Research Unit, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON Canada M5T 1P8.
Int J Qual Health Care. 2014 Apr;26(2):136-43. doi: 10.1093/intqhc/mzu008. Epub 2014 Feb 11.
To assess which client events should be considered reportable and preventable in home care (HC) settings in the opinion of HC safety experts.
Patient safety in acute care settings has been well documented; however, there are limited data about this issue in HC. While many organizations collect information about 'incidents', there are no standards for reporting and it is challenging to compare incident rates among organizations.
A 29-item electronic survey that included potential HC safety issues was used in a two-round Delphi study.
Twenty-four pan-Canadian HC safety experts participated in an electronic survey.
Perceived reportability and preventability of patient safety events, HC.
The events that were perceived as being most reportable and preventable included the following: a serious injury related to inappropriate client service plan (e.g. incomplete/inaccurate assessments, poor care plan design, flawed implementation); an adverse reaction requiring emergency room visit or hospitalization related to a medication-related event; a catheter-site infection (e.g. a new peritoneal dialysis infection or peritonitis); any serious event related to care or services that are contrary to current professional or other practice standards (e.g. incorrect treatment regimen, theft, retention of a foreign object in a wound, individual practicing outside scope or competence).
These data represent an important step in the development and validation of standard metrics about client safety in HC. The results address an expanding area of health services where there is a need to improve standardization and reporting.
根据家庭护理（HC）安全专家的意见，评估在家庭护理环境中哪些客户事件应被视为可报告且可预防的。
急性护理环境中的患者安全已有充分记录；然而，关于家庭护理中这一问题的数据有限。虽然许多组织收集“事件”信息，但报告没有标准，且比较各组织间的事件发生率具有挑战性。
在两轮德尔菲研究中使用了包含潜在家庭护理安全问题的29项电子调查问卷。
24名加拿大全国性的家庭护理安全专家参与了电子调查。
家庭护理中患者安全事件的可报告性和可预防性。
被认为最具可报告性和可预防性的事件包括以下这些：与不适当的客户服务计划相关的严重伤害（例如评估不完整/不准确、护理计划设计不佳、实施有缺陷）；与药物相关事件有关的需要急诊就诊或住院治疗的不良反应；导管部位感染（例如新的腹膜透析感染或腹膜炎）；与违反当前专业或其他实践标准的护理或服务相关的任何严重事件（例如治疗方案错误、盗窃、伤口中异物残留、超出范围或能力执业）。
这些数据是家庭护理中客户安全标准指标制定和验证的重要一步。结果涉及卫生服务中一个不断扩大的领域，在该领域需要提高标准化和报告水平。
