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Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 22, 2010
结果对医生对护理适当性的判断的影响
R A Caplan1, K L Posner, F W Cheney
1Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA 98111.
JAMA
|April 17, 1991
概括
永久性伤害显著影响人们对护理的适当性. 麻醉科医生认为护理对永久性结果不太适合,这突出了医疗评论中的结果严重性偏差.
科学领域:
- 医学伦理学医学伦理学
- 患者安全 患者安全
- 麻醉学 麻醉学
背景情况:
- 评估医疗保健的适当性对于质量改善至关重要.
- 患者结局严重程度对护理判断的影响尚未完全理解.
- 麻醉学为研究不良事件及其感知因果关系提供了一个背景.
研究的目的:
- 调查永久性伤害是否比临时性伤害更有可能被评为不适当的护理.
- 为了确定麻醉后果的严重程度是否会影响对护理适当性的判断.
主要方法:
- 112名麻醉师审查了21个匿名的麻醉不良结果的病例.
- 病例呈现为匹配的对,仅在结果的严重程度上 (暂时与永久) 存在差异.
- 审查人员在不了解研究意图的情况下对护理的适当性进行了评价 (适当,不太适合,无法判断).
主要成果:
- 在71%的病例中,结果严重程度和护理适当性等级之间存在显著的反向关系.
- 当结果从暂时变为永久时,适当护理评级下降了31%.
- 当结果从永久变为临时时,适当护理评级增加了28%.
结论:
- 副作用的严重程度显著影响医疗护理的适当性.
- 医生审查员可能会表现出结果偏见,患者的结果会影响他们对先前护理的判断.
- 这种偏见对医疗失误诉讼,同行评审和医疗保健质量评估有影响.
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