関連する実験動画
医療における有害事象の研究のための代替戦略です
L B Andrews1, C Stocking, T Krizek
1Chicago-Kent College of Law and American Bar Foundation, IL 60661-3691, USA.
Lancet (London, England)
|February 1, 1997
まとめ
病院での有害事象は,しばしば過小評価されています. この研究では,インタラクティブおよび管理上のエラーは,個々のエラーに加えて,患者の被害に大きく寄与しており,包括的な予防戦略の必要性を強調しています.
科学分野:
- 医療の質と安全について
- 医療ミス分析 医療ミス分析
- 患者の研究成果に関する研究
背景:
- 伝統的な有害事象データは,医療記録に依存しており,実際の発生率を潜在的に過小評価しています.
- 病院での有害事象は,患者の安全と医療費に影響を与える重要な懸念事項です.
- 有害事象の範囲を理解することは,効果的な予防戦略の開発に不可欠です.
研究 の 目的:
- 病院医療における有害事象の発生率と範囲の理解を深めること.
- 有害事象の原因と要因を特定する.
- 副作用分析のためのデータ源として,臨床会議での議論の有用性を調査する.
主な方法:
- 展望的,観察的研究デザインが採用されました.
- エスノグラファーは,3つの病院ユニットで,通常の臨床会議で患者のケアに関する議論を質的に観察しました.
- 議論された有害事象とその原因をコードする分類スキームが開発されました.
主要な成果:
- 1047人の患者の17.7%が少なくとも1件の重篤な有害事象を経験した.
- 副作用は,入院期間 (約1年) に伴い増加しました. 1日あたり6%).
- 原因には,個々の要因 (37.8%),相互作用要因 (15.6%),行政決定 (9.8%) が含まれていた.
結論:
- 有害事象は,インタラクティブおよび管理上のエラーを含む幅広い原因から生じます.
- 臨床会議における医療従事者の議論は,積極的なエラー防止のための貴重なデータを提供します.
- 患者の安全性を向上させるためには,体系的および管理的な原因への注意が不可欠である.
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