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在外科手术危机管理中识别,理解和最小化无意识的认知偏见:叙事审查
Luying Yan1, Kunal Karamchandani2,3, Robert R Gaiser1,2
1From the Yale University School of Medicine, New Haven, Connecticut.
Anesthesia and analgesia
|October 24, 2023
概括
无意识的认知偏见 (UCB) 可以影响临床决策,导致患者护理中的错误. 临床决策支持工具在缓解这些偏见和改善关键事件期间患者安全方面表现有前途.
科学领域:
- 医疗决策的制定能力
- 认知心理学 认知心理学
- 患者安全 患者安全
背景情况:
- 快速的临床决策通常依赖于心理捷径,增加对无意识认知偏见 (UCB) 的易感性.
- 在临床环境中,UCBs可能会对诊断,沟通,干预和管理产生负面影响.
- 周期性危机管理特别容易受到UCB的影响.
研究的目的:
- 审查关于UCB及其对外科手术期间危机管理的影响的文献.
- 为了确定临床相关的UCBs在术后的背景下.
- 讨论在临床决策中减轻UCB的策略.
主要方法:
- 关于UCBs在外科手术期间危机管理中的文献叙述性综述.
- 出版物使用叙事评论文章评估尺度 (SANRA) 进行了选择.
- 在医学文献中调查的19个临床相关的UCB中确定了9个.
主要成果:
- UCBs可能导致诊断不准确,沟通问题和治疗延迟.
- 关于审议思维的正式培训在减少UCB方面取得了有限的成功.
- 临床决策支持工具 (CDST) 有效地增强了深思熟虑的决策,并减少了UCB入侵.
结论:
- 在术后危机管理期间,UCB对患者安全构成重大风险.
- CDST提供了一种有希望的方法来提高诊断精度和患者的治疗结果.
- 需要进一步的创新来解决UCBs在麻醉学和外科护理方面的不利影响.
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