[在住院期间由于护理而导致的并发症患者安全指标的分析]
F M Escandell Rico1, L Pérez Fernández2
1Departamento de Enfermería, Universidad de Alicante, San Vicente del Raspeig, Alicante, España.
Journal of healthcare quality research
|April 3, 2025
概括
患者安全指标 (PSI) 分析显示,压力 (PSI 03) 和意外撕裂 (PSI 15) 的死亡率较低. 然而,阳性肺胸病 (PSI 06) 和心血管感染 (PSI 07) 表示风险更高,特别是在较小的医院和老年患者.
科学领域:
- 医疗保健质量和安全研究.
- 卫生服务研究和分析.
- 临床风险管理和患者的结果.
背景情况:
- 医疗保健研究和质量机构 (AHRQ) 患者安全指标 (PSI) 对于监测医疗保健质量至关重要.
- 最低基本数据集 (MBDS) 提供了分析患者安全事件的基本数据.
- 了解各医院PSI的差异对于有针对性的质量改善举措至关重要.
研究的目的:
- 分析来自最低基本数据集 (MBDS) 的 AHRQ 患者安全指标 (PSI),以确定改善患者安全的领域.
- 为了比较不同PSI的发病率,平均停留率和死亡率.
- 调查影响患者安全结果的因素,包括患者人口统计和医院特征.
主要方法:
- 采用了观察性,描述性和回顾性研究设计.
- 分析了2021年342家国家卫生系统医院的CMBD医院出院注册表的数据.
- 检查了四种特定的PSI:压力 (PSI 03),阳性肺胸 (PSI 06),意外刺伤或撕裂 (PSI 15),以及与心血管相关的血液感染 (PSI 07).
主要成果:
- 在PSI 06 (Iatrogenic pneumothorax) 和PSI 07 (CVC相关的血流感染) 中,出院率更高,平均停留时间更长,死亡率增加.
- PSI 03 (压力) 和PSI 15 (意外刺伤或撕裂) 显示出出院人数较少,死亡率降低,平均停留时间较短.
- 在所有分析的指标中,男性的死亡风险略高. 与PSI 06和PSI 07相关的疾病似乎更严重,与延长住院和死亡风险增加相关.
结论:
- 晚年和严重的并发病 (例如,循环系统疾病,瘤) 与增加的死亡率和延长的住院时间显著相关.
- 较小的医院报告说,与较大的医院相比,患者安全风险更高,死亡率更差.
- 研究结果表明,需要优化资源配置和针对弱势患者群体和较小医疗机构的有针对性的干预措施,以提高患者安全.
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