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在家更安全的1型糖尿病护理:基于SEIPS的过程映射与家长和临床医生
Eric S Kirkendall1,2,3, Patrick W Brady4,5,6, Sarah D Corathers5,6,7
1From the Center for Healthcare Innovation, Wake Forest University School of Medicine, Winston-Salem, N.C.
Pediatric quality & safety
|April 4, 2024
概括
儿科药物错误和治疗延迟在1型糖尿病 (T1D) 的儿童的门诊诊环境中很常见. 改善家庭护理支持和诊所-家庭沟通可以减少这些患者安全风险.
科学领域:
- 儿童患者的安全性
- 医疗保健服务研究 医疗服务研究
- 医疗保健中的系统工程
背景情况:
- 在门诊机构,包括家庭护理,儿科医疗错误很常见.
- 患有1型糖尿病 (T1D) 的儿童面临药物错误和治疗延迟.
- 这项研究是门诊儿科患者安全学习实验室的初始阶段.
研究的目的:
- 确定导致T1D患者门诊儿童药物错误和治疗延迟的失败.
- 探索提高儿童T1D管理中的患者安全的潜在解决方案.
- 解决家庭T1D儿童护理的关键缺口.
主要方法:
- 雇佣了一个跨学科的团队 (家长,安全研究人员,临床医生).
- 基于患者安全利用系统工程倡议 (SEIPS) 的过程映射.
- 通过家庭药物审查,观察,图表审查,家长调查和故障模式和效应分析 (FMEA) 收集的数据.
主要成果:
- 14名儿童经历了18种药物错误 (每100种药物中有31种);4种错误造成伤害,13种可能造成伤害.
- 在诊所-家庭沟通和家庭管理期间发生了高风险的错误.
- FMEA确定了改善家庭沟通和在疾病期间提供家庭护理支持的干预措施.
结论:
- 多模式方法和基于SEIPS的过程图证实了常见的药物错误和治疗延迟.
- 加强基于家庭的急性疾病管理支持至关重要.
- 改善诊所和家庭之间的沟通道是儿童患者安全的高收益干预措施.
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