问急诊医生他们是否会做一些不同的事情 (WYHDSD) 是否是一个有用的查工具来识别急诊部门的错误?
David Arastehmanesh1, Alyssa Mangino1, Nadia Eshraghi1
1Department of Emergency Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center Boston, Massachusetts.
The Journal of emergency medicine
|September 9, 2023
概括
在急诊室识别医疗错误是一项挑战. 问评审者"你会做一些不同的事情吗?" (WYHDSD) 有效地标记潜在的错误,提高了患者的安全.
科学领域:
- 紧急医疗 紧急医疗
- 患者安全 患者安全
- 医疗错误分析 医学错误分析
背景情况:
- 医疗错误在紧急医疗中很常见,很难被发现.
- 目前用于识别错误的方法不足.
研究的目的:
- 评估"你是否会做一些不同的事情?"的实用性. (WYHDSD) 问题作为识别医疗错误的标记.
- 为了确定WYHDSD是否可以改善急诊室的患者护理.
主要方法:
- 来自学术急诊室的前景数据收集 (2017-2021).
- 纳入标准:在72小时内返回ED并入院,在24小时内转移到ICU,在24小时内到期或患者/提供者的投诉.
- 医生审查员使用电子工具评估病例,并回答WYHDSD问题.
主要成果:
- 对6672个病例进行了审查;5857个病例表明没有偏离标准护理.
- 在WYHDSD问题中,预测错误的灵敏度为97.4%.
- WYHDSD问题具有99.8%的负预测值,表明排除错误的可靠性很高.
结论:
- 审查员会采取不同的行动的案例显示,近乎失误,不良事件和错误的比例更高.
- WYHDSD问题是识别紧急医疗中的潜在医疗错误的宝贵工具.
- 实施WYHDSD问题可以提高急诊室的患者护理和安全.
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