紧急部门的死亡率和传统安全事件报告的有效性
Nancy Jacobson1, Abigail Miller1, Sean A Mackman1
1Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA.
Cureus
|October 20, 2023
概括
紧急部门 (ED) 的死亡率评估显示,几乎所有患者的死亡都是无法预防的. 标准安全报告有效地捕捉了少数可能可预防的死亡,表明ED的患者安全系统强大.
科学领域:
- 紧急医疗 紧急医疗
- 患者安全 患者安全
- 提高质量 提高质量
背景情况:
- 患者死亡率审查对于识别护理,系统和流程中的缺陷至关重要.
- 学术急救部门 (ED) 在及时进行死亡率审查方面面临着独特的挑战,包括可行性和感知到的徒劳性.
- 现有的非ED部门的死亡率审查协议与ED的季度审查过程有所不同.
研究的目的:
- 确定学术ED的可预防死亡率.
- 确定导致ED患者死亡率的因素.
- 评估患者安全报告系统在捕获相关病例方面的有效性.
主要方法:
- 从2019年7月到2020年2月的ED内所有成年患者死亡的回顾性图表审查.
- 排除在医院前,住院楼层或手术室内宣布死亡的患者.
- 评估死亡的特征,可预防性 (利克尔特尺度),有助于因素,以及需要进一步审查.
主要成果:
- 在审查的166起死亡中,99% (n=164) 被认为是无法预防的.
- 由于医疗或系统错误,只有一个病例 (0.6%) 可能是可以预防的;没有一个病例是可以完全预防的.
- 两例 (1.2%) 需要进一步的安全审查,标准报告记录了这些情况.
结论:
- 在ED中,绝大多数死亡是无法预防的,通常是由于终端状况或最大限度的复苏努力.
- 目前的患者安全事件报告系统似乎有效地识别了ED中可能可预防的死亡.
- 这些发现支持现有的审查过程,并强调了在这个学术ED环境中可预防的死亡率较低.
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