访问限制对ED错误的影响
Clifford Michael Marks1, Richard Everard Wolfe2, Shamai Aron Grossman2
1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA. cmarks2@bidmc.harvard.edu.
Internal and emergency medicine
|February 19, 2024
概括
在COVID-19期间限制紧急部门的访客并没有显著增加医疗错误,但家庭的存在以前可以防止一些错误. 需要进一步的研究来平衡公共卫生与患者护理需求.
科学领域:
- 医学错误研究 医学错误研究
- 公共卫生政策 公共卫生政策
- 紧急医疗 紧急医疗
背景情况:
- 在COVID-19大流行期间,紧急部门 (ED) 限制了访客,优先考虑疾病控制,而不是家庭存在的潜在好处.
- 家庭和护理人员提供情感支持,帮助收集病史,改善患者监测,并为患者辩护,可能提高护理质量.
研究的目的:
- 评估COVID-19大流行期间限制ED访客是否导致医疗错误的增加.
- 评估访问者在防止特定类型的ED错误方面的潜在作用.
主要方法:
- 从2017年11月到2022年7月的城市,高等保健,学术ED中的医疗错误的回顾性审查.
- 分析的重点是五种错误类型,容易受到访客干预的影响:不充分的病史,不充分的监测,跌倒,错误的患者过敏药物和错误的剂量.
- 为了进行比较,错误被分类为流行前 (温和的访问) 和流行期间 (受限的访问).
主要成果:
- 在大流行前 (3.5%) 和大流行 (4.8%) 期间,五种研究的错误类型的比率没有统计学上显著的差异 (p=0.29).
- 虽然访问者在11.1%的流行前错误中防止了伤害,但这发生在0%的流行错误中 (p=0.23).
- 与疫情前的错误 (70.8%),特别是监测错误 (p=0.16) 相比,更高比例的流行病错误 (92.6%) 被认为可能可以通过访客的存在来预防.
结论:
- 这项研究没有发现,由于大流行期间的游客限制,医疗错误的统计显著增加.
- 定性审查表明,家庭的存在可能会防止疫情前的错误,也可能会防止许多疫情后的错误.
- 需要进行更大规模的试验,以量化访客存在对错误率的影响,并制定最佳的政策,平衡公共卫生和患者护理.
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