Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Cairns Library, University of Oxford Health Care Libraries, Oxford, UK.
BMJ Open. 2019 Apr 8;9(4):e025969. doi: 10.1136/bmjopen-2018-025969.
Failure to rescue is defined as mortality after complications during hospital care. Incidence ranges 10.9%-13.3% and several national reports such as National Confidential Enquiry into Patient Outcomes and Death and National Institute of Clinical Excellence CG 50 highlight failure to rescue as a significant problem for safe patient care.To avoid failure to rescue events, there must be successful escalation of care. Studies indicate that human factors such as situational awareness, team working, communication and a culture promoting safety contribute to avoidance of failure to rescue events. Understanding human factors is essential to developing work systems that mitigate barriers and facilitate prompt escalation of care. This qualitative evidence synthesis will identify and synthesise what is known about the human factors that affect escalation of care.
We will search MEDLINE (Ovid), EMBASE (Ovid) and CINAHL, between database inception and 2018, for studies describing human factors affecting failure to rescue and/or care escalation. A search strategy was developed by two researchers and a medical librarian. Only studies exploring in-hospital (ward) populations using qualitative data collection methods will be included. Screening will be conducted by two researchers. We are likely to undertake a thematic synthesis, using the Thomas and Harden framework. Selected studies will be assessed for quality, rigour and limitations. Two researchers will extract and thematically synthesise codes using a piloted data extraction tool to develop analytical themes.
The qualitative evidence synthesis will use available published literature and no ethical approval is required. This synthesis will be limited by the quality of studies, rigour and reproducibility of study findings. Results will be published in a peer-reviewed journal, publicised at conferences and on social media.
CRD42018104745.
抢救失败是指在医院治疗期间发生并发症后的死亡率。发病率在 10.9%-13.3%之间，许多国家的报告，如国家患者结局和死亡保密调查以及国家临床卓越研究所 CG50，都强调抢救失败是安全患者护理的一个重大问题。为了避免抢救失败事件，必须成功地升级护理。研究表明，情境意识、团队合作、沟通和促进安全的文化等人为因素有助于避免抢救失败事件。了解人为因素对于开发减轻障碍和促进及时升级护理的工作系统至关重要。这项定性证据综合将确定并综合影响护理升级的人为因素。
我们将在数据库创建以来至 2018 年期间，在 MEDLINE（Ovid）、EMBASE（Ovid）和 CINAHL 中搜索描述影响抢救失败和/或护理升级的人为因素的研究。两名研究人员和一名医学图书馆员制定了搜索策略。只有使用定性数据收集方法探索院内（病房）人群的研究才会被包括。两名研究人员将进行筛选。我们可能会使用托马斯和哈登框架进行主题综合。将对选定的研究进行质量、严谨性和局限性评估。两名研究人员将使用经过试点的数据提取工具提取和主题综合代码，以开发分析主题。
定性证据综合将使用现有的已发表文献，不需要伦理批准。这项综合将受到研究质量、研究结果的严谨性和可重复性的限制。结果将在同行评议的期刊上发表，在会议上和社交媒体上宣传。
PROSPERO 注册号：CRD42018104745。
