日惹大学Gadjah Mada学术医院患者安全的描述性分析:使用IHI全球触发工具测量不良事件的案例研究

Novi Zain Alfajri, Domas Fitria Widyasari, Ratna Puspita
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引用次数: 123

摘要

背景:医疗管理是一个非常复杂的多学科过程,涉及多个阶段。在Gadjah Mada大学学术医院(UGM学术医院)的病人护理期间,涉及病人安全的事件要么没有报告,要么是意外发现。根据一些公共卫生研究,只有大约10-20%的事件被报告。本研究旨在为医院管理层提供有关患者安全水平的数据,并为提高服务质量,特别是减少伤害和提高患者安全提供建议。方法:我们的研究通过回顾2015年9月住院成人(n = 60)的患者医疗记录,使用IHI全球不良事件触发工具检测触发事件和不良事件。小组护理旨在反映在UGM学术医院任何地方发生的不良事件,以便所有样本都应由两个模块进行审查。如果有必要,根据患者接受治疗的单位使用所有剩余的三个模块。本研究使用的技术分析是描述性统计。结果:研究发现27例患者(n = 60)发生69起事件/触发因素,其中治疗组47起,手术组16起,重症监护1起,急诊科5起。根据受伤程度,发生的事故需要延长日托时间,需要更多的干预和残疾援助。这些事件没有造成死亡的报告。结论:按模块划分,各类别发生率均以治疗期发生率最高,重症监护期发生率最低。大多数事件导致延长治疗时间,需要更多的干预。在所研究的样本中未报告死亡病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Descriptive Analysis of Patient Safety at Universitas Gadjah Mada Academic Hospital Yogyakarta : A Case Study Using IHI Global Trigger Tool for Measuring Adverse Events
Background: Management of medical treatment is a very complex multi-disciplinary process with many stages. During patient care at Universitas Gadjah Mada Academic Hospital (UGM Academic Hospital) incidents involving patient safety either go unreported or are accidentally found. According to some public health research only about 10-20% of incidents were reported. The purpose of this research aimed to provide data to the management about the level of patient safety and make recommendations to improve service quality, especially to reduce injury and increase patient safety.Methods: Our study was conducted by doing a review of patient medical records of hospitalized adults (n = 60) treated in September 2015 to detect trigger and adverse events using the IHI Global Trigger Tool for Measuring Adverse Events. Group Cares was designed to reflect the adverse events that occurred anywhere in UGM Academic Hopitaltal so that all samples should be reviewed by both modules. All three remaining modules were used if necessary depending on the unit where patients were treated. Technical analysis used in this research was descriptive statistics.Results: The study found 69 incidents / triggers that occurred in 27 patients (n = 60) consisting of 47 incidents in the treatment group, 16 incidents in the surgery group, one incident in intensive care, and 5 incidents at the Emergency Department. Based on the level of injury, the incidents which happened demanded extended day care, requiring more intervention and assistance of disability. No cases of death were reported due to the incidents.Conclusions: The incidence found in all categories according to the modules with the highest incidence was the incidence of treatment and the smallest was in intensive care. Most incidents resulted in extending the duration of treatment and require more intervention. No fatal cases were reported to have resulted in the studied sample.
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