Tokede Bunmi, Yansane Alfa, Walji Muhammad, Rindal D Brad, Worley Donald, White Joel, Kalenderian Elsbeth
From the Department of Diagnostic and Biomedical Sciences, The University of Texas at Houston Health Science Center, Houston, Texas.
Preventative and Restorative Dental Sciences, University of California, San Francisco/ UCSF School of Dentistry, San Francisco, California.
J Patient Saf. 2024 Oct 1;20(7):454-460. doi: 10.1097/PTS.0000000000001255. Epub 2024 Jul 31.
Learning from clinical data on the subject of safety with regards to patient care in dentistry is still largely in its infancy. Current evidence does not provide epidemiological estimates on adverse events (AEs) associated with dental care. The goal of the dental practice study was to quantify and describe the nature and severity of harm experienced in association with dental care, and to assess for disparities in the prevalence of AEs.
Through a multistaged sampling procedure, we conducted in-depth retrospective review of patients' dental and medical records.
We discovered an AE proportion of 1.4% (95% CI, 1.1% to 1.8). At least two-thirds of the detected AEs were preventable. Eight percent of patients who experienced harm due to a dental treatment presented only to their physician and not to the dentist where they originally received care.
Although most studies of AEs have focused on hospital settings, our results show that they also occur in ambulatory care settings. Extrapolating our data, annually, at least 3.3 million Americans experience harm in relation to outpatient dental care, of which over 2 million may be associated with an error.
Measurement is foundational in enabling learning and improvement. A critical first step in preventing errors and iatrogenic harm in dentistry is to understand how often these safety incidents occur, what type of incidents occur, and what the consequences are in terms of patient suffering, and cost to the healthcare system.
从有关牙科患者护理安全问题的临床数据中学习，目前仍处于起步阶段。现有证据并未提供与牙科护理相关的不良事件（AE）的流行病学估计。该牙科实践研究的目标是量化并描述与牙科护理相关的伤害的性质和严重程度，并评估不良事件发生率的差异。
通过多阶段抽样程序，我们对患者的牙科和医疗记录进行了深入的回顾性审查。
我们发现不良事件发生率为1.4%（95%置信区间，1.1%至1.8%）。至少三分之二的已检测到的不良事件是可预防的。因牙科治疗而受到伤害的患者中，有8%仅向其医生就诊，而未向最初接受治疗的牙医处就诊。
尽管大多数关于不良事件的研究都集中在医院环境中，但我们的结果表明，不良事件也发生在门诊护理环境中。根据我们的数据推断，每年至少有330万美国人在门诊牙科护理中受到伤害，其中超过200万可能与失误有关。
测量是促进学习和改进的基础。预防牙科错误和医源性伤害的关键第一步是了解这些安全事件的发生频率、发生的事件类型以及对患者痛苦和医疗系统成本的影响。
