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医疗专业学生临床实习期间安全事件报告系统的开发与实施:观察性研究。

Development and Implementation of a Safety Incident Report System for Health Care Discipline Students During Clinical Internships: Observational Study.

机构信息

Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Alicante, Spain.

Universidad Miguel Hernández, Elche, Spain.

出版信息

JMIR Med Educ. 2024 Jul 18;10:e56879. doi: 10.2196/56879.

Abstract

BACKGROUND

Patient safety is a fundamental aspect of health care practice across global health systems. Safe practices, which include incident reporting systems, have proven valuable in preventing the recurrence of safety incidents. However, the accessibility of this tool for health care discipline students is not consistent, limiting their acquisition of competencies. In addition, there is no tools to familiarize students with analyzing safety incidents. Gamification has emerged as an effective strategy in health care education.

OBJECTIVE

This study aims to develop an incident reporting system tailored to the specific needs of health care discipline students, named Safety Incident Report System for Students. Secondary objectives included studying the performance of different groups of students in the use of the platform and training them on the correct procedures for reporting.

METHODS

This was an observational study carried out in 3 phases. Phase 1 consisted of the development of the web-based platform and the incident registration form. For this purpose, systems already developed and in use in Spain were taken as a basis. During phase 2, a total of 223 students in medicine and nursing with clinical internships from universities in Argentina, Brazil, Colombia, Ecuador, and Spain received an introductory seminar and were given access to the platform. Phase 3 ran in parallel and involved evaluation and feedback of the reports received as well as the opportunity to submit the students' opinion on the process. Descriptive statistics were obtained to gain information about the incidents, and mean comparisons by groups were performed to analyze the scores obtained.

RESULTS

The final form was divided into 9 sections and consisted of 48 questions that allowed for introducing data about the incident, its causes, and proposals for an improvement plan. The platform included a personal dashboard displaying submitted reports, average scores, progression, and score rankings. A total of 105 students participated, submitting 147 reports. Incidents were mainly reported in the hospital setting, with complications of care (87/346, 25.1%) and effects of medication or medical products (82/346, 23.7%) being predominant. The most repeated causes were related confusion, oversight, or distractions (49/147, 33.3%) and absence of process verification (44/147, 29.9%). Statistically significant differences were observed between the mean final scores received by country (P<.001) and sex (P=.006) but not by studies (P=.47). Overall, participants rated the experience of using the Safety Incident Report System for Students positively.

CONCLUSIONS

This study presents an initial adaptation of reporting systems to suit the needs of students, introducing a guided and inspiring framework that has garnered positive acceptance among students. Through this endeavor, a pathway toward a safety culture within the faculty is established. A long-term follow-up would be desirable to check the real benefits of using the tool during education.

TRIAL REGISTRATION

Trial Registration: ClinicalTrials.gov NCT05350345; https://clinicaltrials.gov/study/NCT05350345.

摘要

背景

患者安全是全球卫生系统医疗实践的一个基本方面。已证明安全实践(包括事件报告系统)在预防安全事件再次发生方面具有重要价值。然而,该工具对于医疗学科学生的可及性并不一致,限制了他们能力的获得。此外,没有工具可以让学生熟悉分析安全事件。游戏化已成为医疗保健教育中的一种有效策略。

目的

本研究旨在开发一种针对医疗学科学生特定需求的事件报告系统,命名为学生安全事件报告系统。次要目标包括研究不同学生群体在使用该平台方面的表现,并对他们进行正确报告程序的培训。

方法

这是一项在三个阶段进行的观察性研究。第 1 阶段包括开发基于网络的平台和事件登记表。为此,以西班牙已开发并使用的系统为基础。在第 2 阶段,来自阿根廷、巴西、哥伦比亚、厄瓜多尔和西班牙的医学院和护理学院的 223 名有临床实习经验的学生参加了一个介绍性研讨会,并获得了平台的访问权限。第 3 阶段同时进行,包括对收到的报告进行评估和反馈,以及让学生有机会对该过程发表意见。获得了有关事件的描述性统计信息,并对组间的平均值进行了比较,以分析得分。

结果

最终的表格分为 9 个部分,共包含 48 个问题,允许输入有关事件、其原因以及改进计划的建议的数据。该平台包括一个个人仪表板,显示已提交的报告、平均分数、进展情况和分数排名。共有 105 名学生参加,提交了 147 份报告。事件主要发生在医院环境中,以护理相关并发症(87/346,25.1%)和药物或医疗产品的影响(82/346,23.7%)为主。最常见的原因与混淆、疏忽或分心有关(49/147,33.3%)和缺乏过程验证(44/147,29.9%)。不同国家(P<.001)和性别(P=.006)的最终平均得分存在统计学显著差异,但研究之间(P=.47)则没有。总体而言,参与者对使用学生安全事件报告系统的体验给予了积极评价。

结论

本研究提出了一种针对学生需求的报告系统的初步调整,引入了一个具有指导和激励作用的框架,得到了学生的积极认可。通过这项工作,在学院内建立了一种安全文化的途径。长期随访将是理想的,可以检查在教育中使用该工具的实际益处。

试验注册

ClinicalTrials.gov NCT05350345; https://clinicaltrials.gov/study/NCT05350345。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/181d/11294782/125d1050ebd6/mededu_v10i1e56879_fig1.jpg

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