集中治療室で看護師による心臓発作の流行が起きている
J J Sacks1, D F Stroup, M L Will
1Division of Field Services, Centers for Disease Control, Atlanta, GA 30333.
JAMA
|February 5, 1988
まとめ
集中治療室 (ICU) は,1人の看護師に関連した心臓発作の流行を経験しました. この看護師が診察した患者は47.5倍リスクが高く,彼女が去ると流行が止まった.
科学分野:
- クリティカルケア・メディシン
- 患者の安全性について
- エピデミオロジー エピデミオロジー
背景:
- 集中治療室 (ICU) は,有害事象のリスクが高い環境です.
- 副作用のパターンと原因を特定することは,患者の安全にとって極めて重要です.
- 異常な心臓発作のクラスターは,夕方のシフト中に観察されました.
研究 の 目的:
- ICUの夜のシフト中に発生する心臓発作の流行を明らかに調査するためです.
- これらの有害事象との潜在的な危険因子および関連性を特定する.
- 増加した心停止率の原因を特定するために.
主な方法:
- 1983年から1985年の間にICUに入院した2,219人の事後のレビュー.
- 1984年1月から1985年3月の間に行われた88件の夜勤の心臓発作の分析.
- 患者因子 (年齢,性別,疾患の重症度,術後の状態) を調整するためのロジスティック回帰分析.
- 心停止の特徴の専門家による臨床レビュー.
主要な成果:
- 特定の看護師 (看護師 14) は,流行期間中の心臓発作の65%の介護者でした.
- 看護師14の患者は,他の看護師の患者と比較して47.5倍高い心停止リスクを持っていた.
- 看護師14の患者の心停止は,原因不明の高血量症と予期せぬタイミングと一致する可能性が高くなりました.
- 心臓発作の流行は,看護師14号がICUから退院した時に止まった.
結論:
- 1人の医療従事者がICUでの心臓発作の流行と強く関連していた.
- この発見は,有害事象の潜在的イアトロゲン原因を示唆しています.
- 医療環境における有害な結果に対する強力な疫学的監視システムの実施を推奨する.
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