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使用ClassIntra系统记录和讨论手术内不良事件:在实施之前进行定性上下文分析的结果
Monika Finsterwald1, Zuzanna Kita2, Salome Dell-Kuster3,4,5
1Institute for Implementation Science in Health Care, University of Zurich, Universitätstrasse 84, Zürich 8006, Switzerland.
这项研究发现,手术签名不一致地执行,阻碍了对手术内不良事件 (AE) 的系统记录. 然而,在签约期间对AE讨论实施ClassIntra®被认为是改善患者护理和外科安全的积极因素.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者安全 患者安全
- 外科手术的结果
背景情况:
- 术内不良事件 (AE) 对患者和医疗保健系统构成重大风险.
- 世界卫生组织的外科安全清单旨在减少外科病发率和死亡率.
- 检查清单的退出组件通常执行不好,忽视了关于AE和术后管理的关键讨论.
研究的目的:
- 评估当前的实践和实施内部操作AE系统记录的决定因素.
- 评估人们对ClassIntra®的看法,ClassIntra®是对手术内AEs的分类系统.
- 了解在外科手术签约期间AE讨论的实施.
主要方法:
- 在瑞士和荷兰的9家医院进行了定性上下文分析.
- 与跨学科的外科工作人员进行了近100次半结构面试.
- 在CFIR和ERIC的指导下,利用了快速分析和概念结构定性内容分析.
主要成果:
- 手术的退出并没有得到一致的实施;手术期间的副作用并没有被系统地记录或讨论.
- 大多数员工认为ClassIntra®对于学习和术后护理是可行的和有益的.
- 确定了各种障碍和促进因素,影响了内部操作AE的记录和讨论.
结论:
- 目前关于内部操作AE和签约的现行做法需要改进.
- 一般来说,ClassIntra®的实施被认为是积极的,为改进的外科安全策略提供了基础.
- 调查结果为开发多方面的实施策略提供了洞察力,以提高签约性能和AE管理.
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