From the NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, Manchester.
Centre for Primary Care, Institute of Population Health, University of Manchester, Williamson Building, Manchester.
J Patient Saf. 2019 Dec;15(4):334-342. doi: 10.1097/PTS.0000000000000380.
Never events (NEs) are serious preventable patient safety incidents and are a component of formal quality and safety improvement (Q&SI) policies in the United Kingdom and elsewhere. A preliminary list of NEs for UK general practice has been developed, but the frequency of these events, or their acceptability to general practitioner (GPs) as a Q&SI approach, is currently unknown. The study aims to estimate (1) the frequency of 10 NEs occurring within GPs' own practices and (2) the extent to which the NE approach is perceived as acceptable for use.
General practitioners were surveyed, and mixed-effects logistic regression models examined the relationship between GP opinions of NE, estimates of NE frequency, and the characteristics of the GPs and their practices.
Responses from 556 GPs in 412 practices were analyzed. Most participants (70%-88%, depending on the NE) agreed that the described incident should be designated as a NE. Three NEs were estimated to have occurred in less than 4% of practices in the last year; however, two NEs were estimated to have occurred in 45% to 61% of the practices. General practitioners reporting that a NE had occurred in their practice in the last year were significantly less likely to agree with the designation as a NE compared with GPs not reporting a NE (odds ratio, 0.42; 95% CI = 0.36-0.49).
The NE approach may have Q&SI potential for general practice, but further work to adapt the concept and content is required.
不良事件（NEs）是严重可预防的患者安全事件，也是英国和其他国家正式质量和安全改进（Q&SI）政策的组成部分。已经为英国全科医生制定了初步的 NE 清单，但这些事件的频率，或全科医生（GPs）对 Q&SI 方法的接受程度，目前尚不清楚。本研究旨在估计：（1）在全科医生自己的实践中发生的 10 种 NE 的频率；（2）NE 方法被认为是可接受的用于使用的程度。
对全科医生进行了调查，并使用混合效应逻辑回归模型研究了全科医生对 NE 的看法、NE 频率的估计值以及全科医生及其实践的特征之间的关系。
对 412 个实践中的 556 名全科医生的回应进行了分析。大多数参与者（取决于 NE，为 70%-88%）同意应将描述的事件指定为 NE。有三个 NE 估计在上一年发生在不到 4%的实践中；然而，有两个 NE 估计发生在 45%-61%的实践中。与未报告 NE 的全科医生相比，报告上一年在自己的实践中发生了 NE 的全科医生不太可能同意将其指定为 NE（比值比，0.42；95%CI=0.36-0.49）。
NE 方法可能对全科医学具有 Q&SI 的潜力，但需要进一步的工作来调整概念和内容。
