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在困难的呼吸道管理中认知错误的发生率:从儿科困难输管注册表的推断人类因素研究
Martina Bordini1, Luca Orsini2, Simon Y W Li3
1Department of Anesthesia & Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; DIMEC, University of Bologna, Bologna, Italy.
认知错误发生在近20%的儿科呼吸道困难病例中,增加了并发症风险. 解决这些错误对于在具有挑战性的气道管理场景中改善患者的治疗结果至关重要.
科学领域:
- 麻醉学 麻醉学
- 患者安全 患者安全
- 认知心理学 认知心理学
背景情况:
- 认知错误被认为是医疗保健环境中低于最佳决策的贡献者.
- 在儿科困难的呼吸道管理中,认知错误的患病率和影响在很大程度上仍未得到量化.
- 了解这些错误对于提高复杂手术过程中的患者安全至关重要.
研究的目的:
- 在儿科困难的呼吸道管理过程中识别认知错误.
- 确定与这些错误相关的患者和临床医生因素.
- 评估认知错误对儿科呼吸道管理不良结果的贡献.
主要方法:
- 儿科难以输入管 (PeDI) 登记册的回顾性分析.
- 纳入标准:至少有三次输入管试验的病例.
- 使用适应的定义和预定义的临床终点发现的认知错误.
主要成果:
- 在17.4%的病例中存在认知错误,固定错误最常见.
- 非麻醉学家的临床医生显示认知错误的几率更高.
- 认知错误显著增加了并发症的风险 (aOR 1.86) 和多个错误的严重并发症 (aOR 2.48).
结论:
- 在儿科困难的呼吸道管理中,认知错误很常见,在近20%的病例中发生.
- 认知错误和并发症风险增加之间存在强烈的关联.
- 需要进一步的研究来完善错误定义,并制定有针对性的缓解策略.
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