在重症监护中检测不良事件的方法:系统性审查
Jay Gorman1, Oleksa Rewa1, Janice Kung2
1Department of Critical Care Medicine, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, AB, Canada.
Critical care explorations
|September 23, 2025
概括
这次审查分析了ICU中不良事件检测方法,发现结合训练有素观察和事件报告等技术可以提高患者安全. 标准化定义和实施实践变化对于更好的结果至关重要.
科学领域:
- 临界护理医学 临界护理医学
- 患者安全研究 患者安全研究
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 在重症监护室 (ICU) 的不良事件对患者的安全构成重大风险.
- 有效的检测方法对于识别和减轻这些事件至关重要.
- 目前的方法在新生儿,儿科和成人ICU设置中各不相同.
研究的目的:
- 系统地审查和描述ICU中使用的不良事件检测方法.
- 总结不同检测策略的性能特征.
- 通过基于证据的见解,为患者安全倡议提供信息.
主要方法:
- 在多个数据库 (Ovid MEDLINE,Embase,CINAHL,Cochrane Library,Google Scholar) 中进行系统的文献搜索.
- 独立的选和文章的全文审查由两位评论员进行.
- 在同行评审期刊中包含关于不良事件检测方法的原始研究.
主要成果:
- 分析了新生儿,儿科和成人ICU中的59项研究.
- 事件报告 (IR),触发工具的使用,训练观察 (TO) 和结构化审查是常见的方法.
- 训练观察发现了最多的不良事件 (57.3每100个患者日),而IR发现了最少的不良事件 (6.4).
- 只有20%的研究报告了质量改善举措.
结论:
- 建议结合多种不良事件检测方法,以获得全面的结果.
- 为了更好的比较,需要对不良事件定义和危害水平进行标准化.
- 加强在检测后传播实践变化的重点对于患者安全至关重要.
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