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1.
Curr Opin Anaesthesiol ; 33(6): 793-799, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33002958

RESUMO

PURPOSE OF REVIEW: Recognition of the increasing maternal mortality rate in the United States has been accompanied by intense efforts to improve maternal safety. This article reviews recent advances in maternal safety, highlighting those of particular relevance to anesthesiologists. RECENT FINDINGS: Cardiovascular and other chronic medical conditions contribute to an increasing number of maternal deaths. Anesthetic complications associated with general anesthesia are decreasing, but complications associated with neuraxial techniques persist. Obstetric early warning systems are evolving and hold promise in identifying women at risk for adverse intrapartum events. Postpartum hemorrhage rates are rising, and rigorous evaluation of existing protocols may reveal unrecognized deficiencies. Development of regionalized centers for high-risk maternity care is a promising strategy to match women at risk for adverse events with appropriate resources. Opioids are a growing threat to maternal safety. There is growing evidence for racial inequities and health disparities in maternal morbidity and mortality. SUMMARY: Anesthesiologists play an essential role in ensuring maternal safety. While continued intrapartum vigilance is appropriate, addressing the full spectrum of contributors to maternal mortality, including those with larger roles beyond the immediate peripartum time period, will be essential to ongoing efforts to improve maternal safety.


Assuntos
Analgesia Obstétrica/tendências , Anestesia Obstétrica/tendências , Anestesiologistas/psicologia , Parto Obstétrico/tendências , Mortalidade Materna/tendências , Hemorragia Pós-Parto/prevenção & controle , Analgesia Obstétrica/efeitos adversos , Analgesia Obstétrica/métodos , Anestesia Obstétrica/efeitos adversos , Anestesia Obstétrica/métodos , Parto Obstétrico/efeitos adversos , Parto Obstétrico/métodos , Feminino , Humanos , Serviços de Saúde Materna/normas , Erros Médicos/prevenção & controle , Gravidez , Complicações na Gravidez , Estados Unidos
2.
Anesth Analg ; 131(4): 1217-1227, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925343

RESUMO

BACKGROUND: Manual processes for verifying patient identification before blood transfusion and documenting this pretransfusion safety check are prone to errors, and compliance with manual systems is especially poor in urgent operating room settings. An automated, electronic barcode scanner system would be expected to improve pretransfusion verification and documentation. METHODS: Audits were conducted of blood transfusion documentation under a manual paper system from January to October 2014. An electronic barcode scanning system was developed to streamline transfusion safety checking and automate documentation. This system was implemented in 58 operating rooms between October and December 2014, with follow-up compliance audits through December 2015. The association of barcode scanner implementation with transfusion documentation compliance was assessed using an interrupted time series analysis. Anesthesia providers were surveyed regarding their opinions on the electronic system. In mid-2016, the scanning system was modified to transfer from the Metavision medical record system to Epic OpTime. Follow-up analysis assessed performance of this system within Epic during 2017. RESULTS: In an interrupted time series analysis, the proportion of units with compliant documentation was estimated to be 19.6% (95% confidence interval [CI], 10.7-25.6) the week before scanner implementation, and 74.4% (95% CI, 59.4-87.4) the week after implementation. There was a significant postintervention level change (odds ratio 10.80, 95% CI, 6.31-18.70; P < .001) and increase in slope (odds ratio 1.14 per 1-week increase, 95% CI, 1.11-1.17; P < .001). After implementation, providers chose to use the new electronic system for 98% of transfusions. Across the 2 years analyzed (15,997 transfusions), the electronic system detected 45 potential transfusion errors in 27 unique patients, and averted transfusion of 36 mismatched blood products into 20 unique patients. A total of 69%, 86%, and 88% of providers reported the electronic system improved patient safety, blood transfusion workflow, and transfusion documentation, respectively. When providers used the barcode scanner, no transfusion errors or reactions were reported. The scanner system was successfully transferred from Metavision to Epic without retraining staff or changing workflows. CONCLUSIONS: A barcode-based system designed for easy integration to different commonly used anesthesia information management systems was implemented in a large urban academic hospital. The system allows a single user with the assistance of a software system to perform and document pretransfusion safety verification. The system improved transfusion documentation compliance, averted potential transfusion errors, and became the preferred method of blood transfusion safety checking.


Assuntos
Transfusão de Sangue/métodos , Processamento Eletrônico de Dados , Registros Eletrônicos de Saúde/organização & administração , Salas Cirúrgicas/organização & administração , Adulto , Documentação , Fidelidade a Diretrizes , Humanos , Análise de Séries Temporais Interrompida , Erros Médicos/prevenção & controle , Segurança do Paciente , Melhoria de Qualidade , Fluxo de Trabalho
3.
Artigo em Inglês | MEDLINE | ID: mdl-32872189

RESUMO

Clinical risk management constitutes a central element in the healthcare systems in relation to the reverberation that it establishes, and as regards the optimization of clinical outcomes for the patient. The starting point for a right clinical risk management is represented by the identification of non-conforming results. The aim of the study is to carry out a systematic analysis of all data received in the first three years of adoption of a reporting system, revealing the strengths and weaknesses. The results emerged showed an increasing trend in the number of total records. Notably, 86.0% of the records came from the medical category. Moreover, 41.0% of the records reported the possible preventive measures that could have averted the event and in 30% of the reports are hints to be put in place to avoid the repetition of the events. The second experimental phase is categorizing the events reported. Implementing the reporting system, it would guarantee a virtuous cycle of learning, training and reallocation of resources. By sensitizing health workers to a correct use of the incident reporting system, it could become a virtuous error learning system. All this would lead to a reduction in litigation and an implementation of the therapeutic doctor-patient alliance.


Assuntos
Coleta de Dados/métodos , Erros Médicos/prevenção & controle , Segurança do Paciente , Qualidade da Assistência à Saúde/estatística & dados numéricos , Gestão de Riscos/organização & administração , Gestão da Segurança/estatística & dados numéricos , Hospitais Universitários , Humanos , Itália , Auditoria Administrativa , Erros Médicos/estatística & dados numéricos , Sistemas Computadorizados de Registros Médicos , Gestão da Segurança/organização & administração , Gestão da Qualidade Total/organização & administração
4.
Medicine (Baltimore) ; 99(31): e21425, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756147

RESUMO

Best practices for how to respond are unclear when a medical error is discovered in a different system (inter-system medical error discovery or IMED). This qualitative study explored medical error professionals' views on disclosure, feedback, and reporting in these scenarios.We conducted semi-structured telephone interviews from January to September 2018 with 15 medical error professionals from 5 regions of the United States. Interview guides addressed perspectives on best practice, minimum obligations, and mediating factors with respect to IMED. Each transcript was coded independently by two investigators. Analysis followed the inductive approach of interpretive description.Medical error professionals expressed diverse views about minimum obligations and best practices for physicians when responding to IMED events. All cited practical barriers to disclosure, feedback, and reporting in these scenarios. There was general consensus that clear-cut, harmful errors should be disclosed to patients, and most advised investigation and feedback prior to disclosure. Respondents diverged in recommended best practices and thresholds for taking action. All noted the lack of guidance specific to IMED scenarios but differed in how they would extrapolate from more general guidance.While medical error professionals expressed consensus regarding obligations to disclose obvious errors, they differed on particulars. Guidelines or an algorithm could be very useful. Efforts to develop clear guidelines for IMED must take into account these factors, as well as practical and political challenges to communication about errors discovered across systems.


Assuntos
Atitude do Pessoal de Saúde , Guias como Assunto , Erros Médicos/prevenção & controle , Revelação da Verdade , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estados Unidos
5.
Medicine (Baltimore) ; 99(31): e20912, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756081

RESUMO

INTRODUCTION: Adverse events (AE) in care are recognized as a leading cause of mortality and injury in patients. Improving patients' safety is difficult to achieve. Therefore, innovative research strategies are needed to identify errors in subgroups of patients and related severity of outcomes as well as reliably measured efficiency of reproducible strategies to improve safety. This trial aims to evaluate the impact of a combined multiprofessional education program on the rate of AE in neonatal intensive care units (NICUs). METHODS AND ANALYSIS: This is a stepped-wedge cluster randomised controlled trial with 3 clusters each containing 4 units. The study time period will be 20 months. The education program will be implemented within each cluster following a random sequence with a control period, a 4-month transition period and a post-educational intervention period. Eligibility criteria: for clusters: 6 NICUs from Ile-de-France and 6 NICUs from different regions in France; for patients: in-hospital during the study period (November 23, 2015 and November 2, 2017 [inclusion start dates varying by unit]) in one of the 12 NICUs; corrected gestational age ≤42 weeks upon admission; hospitalization period >2 days; and parents informed and not opposed to the use of their newborn's data. A routine occurrence reporting of medical errors and their consequence will take place during the entire study period. The intervention will combine an education to implement a standardized root cause analysis method, creation of bundles (insertion, daily goals, maintenance bundles) to prevent catheter-associated blood-stream infection and a poster to prevent extravasation injuries. OUTCOME: We hypothesize a reduction from 60 (control) to 50 (intervention) AE/1000 patient-days. The primary outcome will be the rate of AE/1000 patient-days in the NICU. TRIAL REGISTRATION NUMBER: NCT02598609, trial registered November 6, 2015. https://clinicaltrials.gov/ct2/show/NCT02598609. ETHICS AND DISSEMINATION: Study approved by the regional ethic committee CPP Ile-de-France III (no 2014-A01751-46). The results will be published in peer-reviewed journals.


Assuntos
Unidades de Terapia Intensiva Neonatal , Erros Médicos/prevenção & controle , Neonatologia/educação , Infecções Relacionadas a Cateter/prevenção & controle , Educação Médica Continuada/métodos , Extravasamento de Materiais Terapêuticos e Diagnósticos/prevenção & controle , Humanos , Recém-Nascido , Segurança do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Curr Opin Anaesthesiol ; 33(5): 698-703, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826627

RESUMO

PURPOSE OF REVIEW: There has been increasing attention to wrong site medical procedures over the last 20 years. This review aims to provide a summary of the current understanding and recommendations for the prevention of wrong-site nerve blocks (WSNB). RECENT FINDINGS: Various procedural, patient, practitioner, and organizational factors have been associated with the risk of WSNB. Recent findings have suggested that the use of a checklist is likely to reduce the incidence of WSNB. However, despite the widespread use of preprocedural checklists, WSNB continue to occur at significant frequency. This may be due to the inability of practitioners and teams to implement checklists correctly or the cognitive errors that prevent checklists from being executed as designed. SUMMARY: Though the evidence is limited, it is recommended that a combination of multiple strategies should be employed to prevent WSNB. These include the use of preprocedural markings, well constructed checklists, time-out/stop-moments, and cognitive/physical aids. Effective implementation requires team education and engagement that empowers all team members to speak up as part of a culture of safety.


Assuntos
Lista de Checagem , Erros Médicos/prevenção & controle , Bloqueio Nervoso/normas , Salas Cirúrgicas/organização & administração , Humanos , Bloqueio Nervoso/métodos , Segurança do Paciente
7.
Aesthetic Plast Surg ; 44(5): 1926-1928, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32671446

RESUMO

The COVID-19 pandemic has had an unprecedented impact on the delivery of healthcare services around the globe. This has resulted in important loss of life for our communities, including health professionals that have been exposed to the disease in their workplace. A human factors approach to the recent changes introduced due to the pandemic can help identify how we can minimize the impact of human error in these circumstances. We hereby present a case study illustrating the application of human factors in the difficult times we are going through at present.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Erros Médicos/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Cirurgia Plástica/métodos , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Controle de Infecções/organização & administração , Masculino , Saúde do Trabalhador , Pandemias/prevenção & controle , Segurança do Paciente , Pneumonia Viral/prevenção & controle , Medição de Risco , Cirurgia Plástica/estatística & dados numéricos
8.
Med Leg J ; 88(1_suppl): 31-34, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32700595

RESUMO

This article considers the recent calls to provide doctors with immunity from medical negligence claims arising out of the Covid-19 pandemic. It provides a critical analysis as to the conditions that would need to be considered for such a policy as well as exploring the wider ramifications.


Assuntos
Infecções por Coronavirus/terapia , Imperícia/legislação & jurisprudência , Erros Médicos/prevenção & controle , Pandemias/legislação & jurisprudência , Segurança do Paciente/legislação & jurisprudência , Pneumonia Viral/terapia , Competência Clínica , Pessoal de Saúde/legislação & jurisprudência , Humanos , Gestão da Segurança/legislação & jurisprudência , Medicina Estatal
9.
N Engl J Med ; 382(26): 2514-2523, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32579812

RESUMO

BACKGROUND: The effects on patient safety of eliminating extended-duration work shifts for resident physicians remain controversial. METHODS: We conducted a multicenter, cluster-randomized, crossover trial comparing two schedules for pediatric resident physicians during their intensive care unit (ICU) rotations: extended-duration work schedules that included shifts of 24 hours or more (control schedules) and schedules that eliminated extended shifts and cycled resident physicians through day and night shifts of 16 hours or less (intervention schedules). The primary outcome was serious medical errors made by resident physicians, assessed by intensive surveillance, including direct observation and chart review. RESULTS: The characteristics of ICU patients during the two work schedules were similar, but resident physician workload, described as the mean (±SD) number of ICU patients per resident physician, was higher during the intervention schedules than during the control schedules (8.8±2.8 vs. 6.7±2.2). Resident physicians made more serious errors during the intervention schedules than during the control schedules (97.1 vs. 79.0 per 1000 patient-days; relative risk, 1.53; 95% confidence interval [CI], 1.37 to 1.72; P<0.001). The number of serious errors unitwide were likewise higher during the intervention schedules (181.3 vs. 131.5 per 1000 patient-days; relative risk, 1.56; 95% CI, 1.43 to 1.71). There was wide variability among sites, however; errors were lower during intervention schedules than during control schedules at one site, rates were similar during the two schedules at two sites, and rates were higher during intervention schedules than during control schedules at three sites. In a secondary analysis that was adjusted for the number of patients per resident physician as a potential confounder, intervention schedules were no longer associated with an increase in errors. CONCLUSIONS: Contrary to our hypothesis, resident physicians who were randomly assigned to schedules that eliminated extended shifts made more serious errors than resident physicians assigned to schedules with extended shifts, although the effect varied by site. The number of ICU patients cared for by each resident physician was higher during schedules that eliminated extended shifts. (Funded by the National Heart, Lung, and Blood Institute; ROSTERS ClinicalTrials.gov number, NCT02134847.).


Assuntos
Unidades de Terapia Intensiva Pediátrica/organização & administração , Internato e Residência/organização & administração , Erros Médicos/estatística & dados numéricos , Segurança do Paciente , Admissão e Escalonamento de Pessoal , Tolerância ao Trabalho Programado , Carga de Trabalho , Estudos Cross-Over , Humanos , Erros Médicos/prevenção & controle , Desempenho Psicomotor/fisiologia , Sono , Fatores de Tempo
11.
PLoS One ; 15(6): e0231569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497074

RESUMO

INTRODUCTION: Electronic Health Records are receiving considerable attention as a valuable tool for managing clinical information. Despite the prospects of Electronic Health Records in developing countries, many pre-implementation assessments target organizational, managerial, and infrastructural readiness, but barely include a detailed examination of health provider readiness. Meanwhile, health provider readiness is a critical success factor for electronic health records in settings where the majority of the workforce is less likely to have basic computer skills. We sought to assess the readiness of health providers for electronic health records in Ghana. MATERIALS AND METHOD: An institutional-based cross-sectional study was conducted among 350 health providers in northern Ghana from June-September 2019. Data were collected using a modified questionnaire on provider readiness. The mean overall readiness was calculated for each respondent. Providers with readiness score below the overall mean score were categorized as not being ready while those at or above the mean score were considered ready. Multiple linear regression was conducted to determine the factors that determine provider readiness. RESULTS: Two hundred and nine health providers responded to the questionnaire (59.7 response rate). The mean overall readiness was 3.61 (SD = .76), mean core readiness was 3.74 (SD = .80), and mean engagement readiness was 3.47 (SD = .67). Using the average overall readiness score as the cut-off for determining being ready and not ready for electronic health records, overall readiness was 54.9%, core readiness was 67.2%, while engagement readiness was 43.1%. Age, sex, old employees compared to new employees, computer literacy, and knowledge of electronic health records were significant determinants of health providers' readiness to adopt electronic health records. CONCLUSION: We observed that health providers were marginally ready for electronic health records adoption. While participants might have expressed dissatisfaction with paper-based records and expressed a desire for electronic health records, they expressed fear of the potential impact of computerized records. We proposed a robust informatics curriculum and capacity building workshops for improving provider readiness for electronic health records.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Registros Eletrônicos de Saúde , Pessoal de Saúde/psicologia , Hospitais/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Gana , Humanos , Masculino , Erros Médicos/prevenção & controle , Pessoa de Meia-Idade , Motivação , Risco , Inquéritos e Questionários , Adulto Jovem
13.
Gastroenterol. hepatol. (Ed. impr.) ; 43(5): 233-239, mayo 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192999

RESUMO

INTRODUCCIÓN: Los errores son muy comunes en la práctica clínica diaria; no obstante, pueden prevenirse. Nuestro objetivo fue identificar los errores más frecuentes en el manejo ambulatorio de los pacientes con enfermedad inflamatoria intestinal (EII). MATERIAL Y MÉTODOS: Se incluyeron pacientes consecutivos diagnosticados de EII atendidos en segunda opinión en nuestra Unidad de EII. Se obtuvieron datos sobre las estrategias que habían realizado los médicos que les atendieron previamente, y se compararon con los procedimientos diagnósticos y terapéuticos actualmente recomendados. RESULTADOS: Se incluyeron 74 pacientes. Previamente a la atención en nuestra Unidad, se había interrogado sobre el tabaquismo en el 50% de los pacientes con enfermedad de Crohn, y en el 29% se promocionó el abandono de este. Al diagnóstico de la EII, en el 16% se había evaluado la infección por el virus de la hepatitis B, en el 15% por el virus de la hepatitis C, y en el 7% por la varicela. El 7% de los pacientes había sido vacunado frente a la hepatitis B, mientras que el 3% frente a la gripe, tétanos y neumococo. El 67% y el 37% de los pacientes con indicación de 5-aminosalicitalos e inmunosupresores, respectivamente, los había recibido. DISCUSIÓN: Los errores en el manejo de los pacientes ambulatorios diagnosticados de EII son muy frecuentes y relevantes


INTRODUCTION: Errors are very common in daily clinical practice; however, they can be prevented. Our aim was to identify the most common errors in the outpatient management of inflammatory bowel disease (IBD) patients. MATERIAL AND METHODS: Patients diagnosed with IBD, being treated at our IBD Unit and who were referred for a second opinion were consecutively enrolled. Data on the strategies implemented by their previous physicians were obtained. These strategies were compared with the currently recommended diagnostic and therapeutic procedures. RESULTS: Seventy-four IBD patients were enrolled. Prior to care in our Unit, screening for tobacco use had been performed in 50% of Crohn's disease patients, while smoking cessation counselling had been provided in 29%. At the time of IBD diagnosis, the hepatitis B virus immunization status had been investigated in 16% of the patients, the hepatitis C virus status in 15%, and the varicella status in 7%. Seven percent of the patients had been vaccinated against hepatitis B virus, and 3% against influenza, tetanus and pneumococcus. Sixty-seven percent of the patients with an indication for use of 5-aminosalicylic acid and 37% of those with an indication for immunosuppressants had received the indicated drug. DISCUSSION: Errors in the outpatient management of IBD patients are very common and relevant


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Inflamatórias Intestinais/epidemiologia , Erros Médicos/prevenção & controle , Serviços de Saúde , Estudos Retrospectivos , Estudos Transversais , Inquéritos e Questionários , Qualidade da Assistência à Saúde/ética , Qualidade da Assistência à Saúde/estatística & dados numéricos
16.
Br J Oral Maxillofac Surg ; 58(5): 577-580, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-101615

RESUMO

Our professional and private lives changed on March 11 2020 when the coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO. By March 16, surgical training was suspended, MRCS and FRCS examinations cancelled and all courses postponed. In theory, essential cancer surgery, emergency and trauma operating will continue. All elective, non-essential cases are currently cancelled. While we adapt to our new ways of working, we remind ourselves that surgeons are flexible, resilient and, ultimately, we are doctors in the first instance. We present a short article on operating during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Coronavirus , Erros Médicos , Pandemias , Pneumonia Viral , Procedimentos Cirúrgicos Operatórios , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Erros Médicos/prevenção & controle , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Operatórios/normas
17.
Br J Oral Maxillofac Surg ; 58(5): 581-584, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-47192

RESUMO

On 30 January 2020, the WHO declared the coronavirus disease 2019 (COVID-19) a public health emergency of international concern. By 11 March 2020, it was designated a pandemic owing to its rapid worldwide spread. In this short article we provide some information that might be useful and help equip colleagues to reduce medical error during a pandemic. We advocate a systems-based approach, rather than an individual's sole responsibility, and, look at ways to provide safer healthcare.


Assuntos
Infecções por Coronavirus , Erros Médicos/prevenção & controle , Pandemias , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Análise de Sistemas
19.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32327450

RESUMO

Causal analysis is a core function of safety programs. Although established protocols exist for conducting root cause analysis for serious safety events, there is limited guidance for apparent cause analysis (ACA) in health care. At our institution, through a novel facilitated ACA approach, we aim to improve safety culture and provide a clear approach to address precursor safety events and near-miss safety events. We define facilitated ACA as limited investigation (scope and duration) of a safety event that resulted in little to no harm. These investigations require fewer resources and focus on preventive strategies. Our facilitated ACA model, with an operational algorithm and structured process, was developed and implemented at our tertiary-care, freestanding, urban pediatric hospital in 2018. Sixty-four ACAs were completed, and 83% were identified with the algorithm. Process measures, including time from event reporting to ACA launch (median 3 days; interquartile range 2-6 days), are tracked. Patient safety consultants averaged 5 hours to complete a facilitated ACA. A median of 3 disciplines or departments participated in each facilitated ACA. Through an iterative process, we implemented a structured process for facilitated ACA, and the model's strength includes (1) right event, (2) right team, (3) right analysis, and (4) right action plans. This novel facilitated ACA model may support organizational cause analysis and improve safety culture with higher-reliability processes.


Assuntos
Erros Médicos/prevenção & controle , Cultura Organizacional , Segurança do Paciente/normas , Gestão da Segurança/normas , Humanos , Gestão da Segurança/métodos
20.
BMC Health Serv Res ; 20(1): 269, 2020 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-32234042

RESUMO

BACKGROUND: This study aims to increase understanding of how patient and family education affects the prevention of medical errors, thereby providing basic data for developing educational contents. METHODS: This descriptive study surveyed patients, families, and Patient Safety Officers to investigate the relationship between educational contents and medical error prevention. The Chi-square test and ANOVA were used to derive the results of this study. The educational contents used in this study consisted of health information (1. current medicines, 2. allergies, 3. health history, 4. previous treatments/tests and complications associated with them) and Speak Up (1. handwashing, 2. patient identification, 3. asking about medical conditions, 4. asking about test results, 5. asking about behaviour and changes in lifestyle, 6. asking about the care plan, 7. asking about medicines, and 8. asking about medicine interactions). RESULTS: In this study, the first criterion for choosing a hospital for treatment in Korea was 'Hospital with a famous doctor' (58.6% patient; 57.7% families). Of the patients and their families surveyed, 82.2% responded that hospitals in Korea were safe. The most common education in hospitals is 'Describe your medical condition', given to 69.0% of patients, and 'Hospitalisation orientation', given to 63.4% of families. The most important factors in preventing patient safety events were statistically significant differences among patients, family members, and Patient Safety Officers (p = 0.001). Patients and families had the highest 'Patient and family participation' (31.0% of patients; 39.4% of families) and Patient Safety Officers had the highest 'Patient safety culture' (47.8%). CONCLUSIONS: Participants thought that educational contents developed through this study could prevent medical errors. The results of this study are expected to provide basic data for national patient safety campaigns and standardised educational content development to prevent medical errors.


Assuntos
Família , Educação em Saúde , Erros Médicos/prevenção & controle , Educação de Pacientes como Assunto , Adulto , Pesquisas sobre Serviços de Saúde , Hospitais , Humanos , Pessoa de Meia-Idade , Segurança do Paciente , República da Coreia , Gestão da Segurança
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