Balogun James A, Adekanmbi Adefisayo, Balogun Folusho M
Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, No 1 Queen Elizabeth road, Ibadan, Nigeria.
Department of Neurosurgery, University College Hospital, Ibadan, Nigeria.
World J Surg. 2019 Mar;43(3):717-722. doi: 10.1007/s00268-018-4836-y.
Medical error (ME) remains central to discussions regarding patient's safety and its frequency appears high in surgical specialties because of some peculiarities. We set out to study the perception of surgical residents about medical errors, their ability to recognize them and predisposition to disclosing their errors.
This was a cross-sectional study among surgical residents at the University College Hospital, Nigeria. Data about their knowledge, perception and recognition of medical errors were obtained. Knowledge and practice of medical error disclosure was also examined. Each of these was scored on Likert scale and scores categorized. Chi-square test and logistic regression were used for analysis with p at <0.05.
92 residents participated and 11(12.0%) were females. 32.6% of the respondents had less knowledge about medical errors and these were significantly junior residents. Residents with poor perception about ME were 43.5% and recent involvement with ME was significantly associated with good perception about ME. Delay in obtaining consultation and delay in diagnosis were identified respectively as MEs by only 40(43.5%) and 31(33.7) of the participants. While 82(89.1%) agreed that all errors should be reported to the consultant, only 20(21.7%) believed patients/relatives should be informed of all errors, while 49(53.3%) were well disposed to disclosing ME. Only 4(4.3%) residents had a formal training on ME.
Knowledge of ME was low among junior residents and residents are less likely to disclose error to patients/relatives. A formal training on ME will impact on their recognition, practice, and disclosure of ME.
医疗差错仍是患者安全讨论的核心问题，由于某些特殊性，其在外科专业中的发生频率似乎较高。我们着手研究外科住院医师对医疗差错的认知、识别能力以及披露差错的倾向。
这是一项针对尼日利亚大学学院医院外科住院医师的横断面研究。获取了他们关于医疗差错的知识、认知和识别情况的数据。还考察了医疗差错披露的知识和实践情况。这些内容均采用李克特量表评分并进行分类。采用卡方检验和逻辑回归进行分析，p值<0.05。
92名住院医师参与研究，其中11名（12.0%）为女性。32.6%的受访者对医疗差错的了解较少，这些人主要是低年资住院医师。对医疗差错认知较差的住院医师占43.5%，近期涉及医疗差错与对医疗差错的良好认知显著相关。只有40名（43.5%）参与者分别将获取会诊延迟和诊断延迟认定为医疗差错，31名（33.7%）参与者将其认定为医疗差错。虽然82名（89.1%）受访者同意所有差错都应报告给上级医师，但只有20名（21.7%）认为应告知患者/家属所有差错，而49名（53.3%）愿意披露医疗差错。只有4名（4.3%）住院医师接受过关于医疗差错的正规培训。
低年资住院医师对医疗差错的知晓率较低，住院医师向患者/家属披露差错的可能性较小。关于医疗差错的正规培训将影响他们对医疗差错的识别、实践和披露。
