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患者の安全への長い道: 患者の安全システムに関する現状報告
Daniel R Longo1, John E Hewett, Bin Ge
1Department of Family and Community Medicine, School of Medicine, University of Missouri-Columbia, MO 65212, USA. longod@health.missouri.edu
JAMA
|December 15, 2005
まとめ
病院の患者安全システムは,医学研究所 (IOM) の報告以来,控えめな進歩を示しています. 医薬品の安全性やコンピュータ化された医師の注文入力などの重要な分野は,IOMの勧告を満たすために加速的な改善が必要です.
科学分野:
- 医療の質の向上 医療の質の向上
- 患者安全システムの分析
- 病院管理研究 病院管理研究
背景:
- インスティテュート・オブ・メディシン (IOM) の報告では,医療上の誤りや品質に関する懸念が強調されています.
- パラダイムシフトが起こり,個々の誤りではなく,ケアシステムに焦点を当てました.
- 患者安全イニシアチブは,患者の品質を向上させ,患者を保護することを目的としています.
研究 の 目的:
- 病院の患者安全システムの現状を評価する.
- 時間の経過とともに患者の安全システムの変化を特定する.
- 2つの協力国におけるIOMの報告書の進展を評価する.
主な方法:
- 2002年と2004年にミズーリ州とユタ州の急性ケア病院の調査.
- 91項目の包括的なアンケートを使用しました.
- 2つの調査に回答した107の病院のコホートを使用して変化を分析しました.
主要な成果:
- 患者安全システムの開発と導入は,控えめでした.
- 一部の病院では,患者安全システムの低下が報告されています.
- 外科手術などの分野では,強力な安全システムを示し,医薬品の安全性は改善されたが,医薬品のコンピューター化された医師注文入力 (CPOE) は34.1%しか実施されなかった.
結論:
- 病院の患者安全システムは,IOMの勧告を満たしていない.
- 患者安全システムの進歩は遅くて懸念される.
- 患者の安全性を向上させるためには,加快した取り組みが不可欠です.
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