在远程初级保健中患者安全:多方法定性研究,结合安全I和安全II分析
Rebecca Payne1, Aileen Clarke1, Nadia Swann1
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BMJ quality & safety
|December 5, 2023
概括
远程初级保健安全事件虽然很少发生,但可能导致严重伤害. 了解沟通不良和系统压力等原因是制定有效的患者安全策略的关键.
科学领域:
- 提供医疗保健服务.
- 患者安全 患者安全
- 定性研究是一种定性研究.
背景情况:
- 远程咨询和分诊在医疗保健中越来越普遍.
- 了解远程接触中的安全事件对于改善患者护理至关重要.
研究的目的:
- 调查远程初级保健接触中安全事故的原因.
- 确定在偏远医疗机构预防安全事故的策略.
主要方法:
- 这是一项多方法定性研究,分析了来自英国初级保健的95起安全事件.
- 对事故原因的回顾性"安全I"分析和对安全和近乎事故的前性"安全II"分析.
- 主题分析和解释综合,通过成员与专家进行核查来改进.
主要成果:
- 安全事件源于不适当的模式,不良的关系,不充分的信息收集和有限的临床评估.
- 后果包括错过/延迟诊断,低估严重程度,以及不充分的随访,特别是对脆弱的患者.
- 诸如资源限制,复杂的途径和高需求等系统性问题有所贡献,员工经常依赖个人主动.
结论:
- 尽管很少见,但远程初级保健安全事件导致严重伤害.
- 该研究提供了患者,工作人员和系统级减缓策略,以提高远程医疗保健的安全性.
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