医生和相关卫生专业人员之间诊断错误的贡献因素的差异:日本全国性的分析
Ikuo Shimizu1, Kiyoshi Shikino2,3, Yukinori Harada4
1Department of Quality and Patient Safety, Chiba University, Chiba, Japan qingshuiyufu@gmail.com.
BMJ open quality
|November 25, 2025
概括
诊断错误很常见,像护士一样的相关卫生专业人员 (AHP) 参与了很大一部分. 针对AHP的有针对性的干预措施对于提高诊断安全性和减少患者伤害至关重要.
科学领域:
- 医疗保健的质量和安全
- 医疗错误分析 医学错误分析
- 专业间合作 专业间合作
背景情况:
- 诊断错误有助于患者的伤害和医疗不当索赔.
- 研究往往忽视了医疗保健专业人员在诊断过程中的作用.
- 沟通缺陷和团队动态影响诊断准确性.
研究的目的:
- 描述国家数据库中诊断错误的特征和模式.
- 比较涉及医生与AHPs的诊断错误.
主要方法:
- 分析了来自1631家医院的445份诊断错误报告 (2010-2023年).
- 使用了修订后的Safer Dx仪器和诊断错误评估和研究 (DEER) 分类学.
- 医生和AHP之间的错误模式和贡献因素的比较.
主要成果:
- 护士参与了19.3%的诊断错误.
- 护士在陈述,病史记录和体检中的错误与错误的相关性更高 (p<0.001).
- 患者因素,观察,报告和培训在涉及护士的错误中更为重要 (p<0.001).
结论:
- 专家评估的非结构化数据为诊断安全提供了更广泛的见解.
- AHP在诊断错误中发挥着至关重要的作用.
- 需要在专业间倡议中进行专业特定的干预,以减少诊断错误和提高患者安全.
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