Shemesh David, Olsha Oded, Goldin Ilya, Danin Sigalit
1 Department of Surgery and Hemodialysis Access Center, Shaare Zedek Medical Center, Jerusalem - Israel.
J Vasc Access. 2015;16 Suppl 9:S118-20. doi: 10.5301/jva.5000370. Epub 2015 Mar 8.
Medical errors can be defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim. Beyond their economic cost and their cost in human lives, errors cause loss of trust in the healthcare system by patients and diminished satisfaction by both patients and health professionals. There are many evidence-based safety-oriented behaviours and interventions that are easily implemented, such as ultrasound-guided central venous catheter insertion, prevention of catheter-related bloodstream infection and more. In vascular access, the development of research in patient safety has raised a variety of issues requiring study in order to provide the optimal patient safety approach. Patients are major contributors to their own safety, and as such, physicians should develop a new approach to involve them in the cycle of decision making through every step of their treatment. There are many opportunities along this path for the patient to be engaged in safety behaviours and for the access team to ensure such behaviours by employing simple strategies. The advent of the access centre, based on multidisciplinary teamwork, has enhanced the potential to improve patient safety by prevention of errors in planning and performing access surgery, avoiding delay in treatment of access malfunction and improving communication between the team members. However, a significant effort in research is still needed in order to implement intervention by evidence-based data focused on patient safety.
医疗差错可定义为计划中的行动未能按预期完成，或使用错误的计划来实现目标。除了其经济成本和人命代价外，差错还会导致患者对医疗系统失去信任，并降低患者和医护人员的满意度。有许多基于证据的注重安全的行为和干预措施很容易实施，比如超声引导下中心静脉导管置入、预防导管相关血流感染等等。在血管通路方面，患者安全研究的发展提出了各种需要研究的问题，以便提供最佳的患者安全方法。患者是自身安全的主要贡献者，因此，医生应制定一种新方法，让患者在治疗的每一步都参与到决策循环中。在这条道路上，患者有很多机会参与安全行为，而血管通路团队可以通过采用简单策略来确保这些行为。基于多学科团队合作的血管通路中心的出现，通过预防血管通路手术规划和实施中的差错、避免血管通路故障治疗的延误以及改善团队成员之间的沟通，增强了提高患者安全的潜力。然而，为了基于聚焦患者安全的循证数据实施干预，仍需要在研究方面做出重大努力。
