Evans Huw P, Cooper Alison, Williams Huw, Carson-Stevens Andrew
a Primary Care Patient Safety (PISA) Research Group, School of Medicine, Cardiff University , Cardiff , Wales.
b Department of Family Practice , Faculty of Medicine, University of British Columbia , Vancouver , Canada.
Hum Vaccin Immunother. 2016 May 3;12(5):1280-1. doi: 10.1080/21645515.2015.1137404. Epub 2016 Feb 22.
Vaccines save millions of lives per annum as an integral part of community primary care provision worldwide. Adverse events due to the vaccine delivery process outnumber those arising from the pharmacological properties of the vaccines themselves. Whilst one in three patients receiving a vaccine will encounter some form of error, little is known about their underlying causes and how to mitigate them in practice. Patient safety incident reporting systems and adverse drug event surveillance offer a rich opportunity for understanding the underlying causes of those errors. Reducing harm relies on the identification and implementation of changes to improve vaccine safety at multiple levels: from patient interventions through to organizational actions at local, national and international levels. Here we highlight the potential for maximizing learning from patient safety incident reports to improve the quality and safety of vaccine delivery.
作为全球社区初级保健服务的一个组成部分，疫苗每年挽救数百万人的生命。疫苗接种过程中出现的不良事件比疫苗本身药理特性引发的不良事件更多。虽然每三名接种疫苗的患者中就有一人会遇到某种形式的差错，但对于这些差错的根本原因以及如何在实际中加以缓解却知之甚少。患者安全事件报告系统和药物不良事件监测为了解这些差错的根本原因提供了丰富的机会。减少危害依赖于识别并实施变革，以在多个层面提高疫苗安全性：从针对患者的干预措施到地方、国家和国际层面的组织行动。在此，我们强调从患者安全事件报告中最大限度汲取经验教训以提高疫苗接种质量和安全性的潜力。
