Hiivala Nora, Mussalo-Rauhamaa Helena, Tefke Hanna-Leena, Murtomaa Heikki
a 1 Oral Public Health, Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki , Helsinki, Finland.
b 2 FINDOS Helsinki, Doctoral Programme in Oral Sciences, University of Helsinki , Helsinki, Finland.
Acta Odontol Scand. 2016;74(2):81-9. doi: 10.3109/00016357.2015.1042040. Epub 2015 May 13.
Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland.
The sample included all available fully resolved dental cases (n = 948) during 2000-2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases.
Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications.
Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods.
牙科领域中关于患者伤害及伤害预防方法的研究较少。本研究旨在识别并描述芬兰向地区国家行政机构（AVIs）和国家福利与健康监督管理局（Valvira）报告的已结案牙科病例全国样本中的牙科患者安全事件（PSI）。
样本包括2000 - 2012年期间（2011年底前开始）所有可获得的已完全解决的牙科病例（n = 948）。病例包括患者及近亲的投诉以及其他当局、雇主、药店等的通报。所分析的病例涉及公立和私立牙科，包括针对牙医和其他牙科护理专业人员的 incident 报告。数据还包括最严重的病例，因为这些病例会报告给Valvira。PSI 根据常见事件类型进行分类，可预防性和严重性评估基于已结案病例决策中的专家意见。
大多数所谓的PSI被证明是有效的，并被评估为具有潜在可预防性。PSI 最常与不同的牙科治疗程序或诊断相关。超过一半的PSI被评估为严重，对患者构成严重风险或造成永久性或长期伤害。PSI风险在有反复投诉和通报的男性普通牙科从业者中最高。
尽管存在一些局限性，但这项基于登记册的研究为改善牙科护理安全提供了新的视角。通过适当且更系统地使用现有的错误预防方法，许多PSI是可以预防 的。
