Department of Surgery, University of Virginia, Charlottesville, VA 22908-0709, USA; Surgical Outcomes Research Center, University of Virginia, Charlottesville, Virginia 22908-0709, USA.
Department of Surgery, University of Virginia, Charlottesville, VA 22908-0709, USA.
J Pediatr Surg. 2022 Apr;57(4):616-621. doi: 10.1016/j.jpedsurg.2021.07.019. Epub 2021 Jul 27.
Medical errors were largely concealed prior to the landmark report "To Err Is Human". The purpose of this systematic scoping review was to determine the extent pediatric surgery defines and studies errors, and to explore themes among papers focused on errors in pediatric surgery.
The methodological framework used to conduct this scoping study has been outlined by Arksey and O'Malley. In January 2020, PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched. Oxford Level of Evidence was assigned to each study; only studies rated Level 3 or higher were included.
Of 3,064 initial studies, 12 were included in the final analysis: 4 cohort studies, and 8 outcome/audit studies. This data represented 5,442,000 aggregate patients and 8,893 errors. There were 6 different error definitions and 5 study methods. Common themes amongst the studies included a systems-focused approach, an increase in errors seen with increased complexity, and studies exploring the relationship between error and adverse events.
This study revealed multiple error definitions, multiple error study methods, and common themes described in the pediatric surgical literature. Opportunities exist to improve the safety of surgical care of children by reducing errors. Original Scientific Research Type of Study: Systematic Scoping Review Level of Evidence Rating: 1.
在具有里程碑意义的报告《人非圣贤，孰能无过》之前，医疗差错在很大程度上被掩盖了。本系统范围综述的目的是确定儿科外科学定义和研究错误的程度，并探讨专注于儿科外科学错误的论文中的主题。
用于进行这项范围研究的方法论框架由 Arksey 和 O'Malley 概述。2020 年 1 月，对 PubMed、Cochrane 系统评价数据库和 Cochrane 对照试验中心注册库进行了检索。为每项研究分配了牛津证据水平；仅包括 3 级或更高水平的研究。
在最初的 3064 项研究中，最终分析纳入了 12 项研究：4 项队列研究和 8 项结果/审计研究。这些数据代表了 5442000 名患者的综合数据和 8893 例错误。有 6 种不同的错误定义和 5 种研究方法。研究中的常见主题包括系统为重点的方法、随着复杂性的增加而增加的错误以及研究错误与不良事件之间的关系。
本研究揭示了儿科外科学文献中存在多种错误定义、多种错误研究方法和常见主题。通过减少错误，可以为儿童手术护理的安全提供改进机会。
系统范围综述 证据水平评级：1。
