紧急部门登机,拥挤和错误
Joshua Kolikof1, Daniel Shaw1, Bryan Stenson1
1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
概括
紧急部门的拥挤和登机并没有直接增加错误,但更高敏度的患者和进入ED的患者面临更大的医疗错误风险. 这强调了有针对性的干预措施的必要性.
科学领域:
- 紧急医疗 紧急医疗
- 患者安全 患者安全
- 医疗保健管理的管理
背景情况:
- 紧急情况 (ED) 部门的拥挤和患者登机是关键的公共卫生问题.
- 这些情况独立地与患者发病率和死亡率的增加有关.
- 需要进一步调查ED拥挤,登机和医疗错误之间的联系.
研究的目的:
- 调查急诊室拥挤和登机以及医疗错误的发生之间的关系.
- 确定ED拥挤和登机是否是部门错误的独立风险因素.
主要方法:
- 一项回顾性队列研究分析了从2018年7月1日到2023年6月30日的250,049例患者接触.
- 计算了事件率比率,控制了患者的年龄,性别,紧急严重性指数 (ESI) 水平,急救工作得分和拥挤激增能力激活.
- 主要的风险是拥挤和登机;利益的结果是存在裁定错误.
主要成果:
- 观察到的整体错误率为每10万例患者中500例.
- 登上ED的患者有更高的错误可能性 (调整后的发病率比率[aIRR]为1.60).
- 高敏度患者 (ESI 1和2) 也显示出更高的错误可能性 (aIRR分别为2.9和1.5).
结论:
- 虽然在本研究中,ED拥挤和登机与更高的错误可能性没有直接相关,但特定的患者因素与风险增加有关.
- 高敏度患者和那些经历ED内登机的患者表现出医疗错误的风险较高.
- 这些发现强调了解决患者敏度和登机状态的重要性,以提高急诊室患者的安全.
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