医疗中心安全状况的定量与定性评估:实施标准安全体系的经验

Javad Vatani, S. Yousefzadeh, Shiva Mohammadjani Kumeleh, F. Mehrabian, A. Davoudi-kiakalayeh
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引用次数: 0

摘要

背景:事故是发生在包括医疗中心在内的所有器官的不可预见的事件,由于不安全的条件和做法而造成损害,有时甚至是不可挽回的伤害。在医疗中心建立安全体系,以防止对患者和医护人员的伤害。目的:本研究旨在评估某医疗中心实施标准安全制度前后的安全状况。材料与方法:本案例研究于2018-2019年在伊朗桂兰省某医院的工作人员中进行。这些资料是通过观察和与员工面谈,以及检查员工是否遵守指示和安全提示收集的。然后,通过计算事故指数,确定针刺伤的可能性。采用系统人为错误减少和预测方法(SHERPA)进行风险评估。结果:选取某医院9个科室进行调查,确定了事故和人为失误。与2018年相比,2019年的事故复发率从11.36下降到4.09 (safe_T_score=-3.14)。利用SHERPA法对妇科病房进行风险评估,发现该科室存在4种重要的错误类型。结论:医院建立安全制度后,针刺伤的发生频率和严重程度均有明显降低。SHERPA方法,详细说明了任务的错误和具体的补救措施,以纠正任务。本研究的结果可为医护人员、管理人员、雇主及安全专家识别及预防事故原因提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quantitative and Qualitative Assessment of Safety Status in a Medical Centre: Experience from Implementing Standard Safety System
Background: An accident is an unforeseen occurrence that happens in all organs, including medical centers, due to unsafe conditions and practices which cause damage and sometimes irreparable injuries. Establishing safety system in the medical center seek to prevent harm to both patients and health care professionals. Objectives: The aim of this study was to assess safety status in a medical center before and after implementing standard safety system. Materials & Methods: This case-study was carried out among the staff of a hospital in Guilan province, Iran in 2018-2019. The information was collected through observation and interview with staff and checking the observance of instructions and safety tips. Then, the possibility of needle stick injury was identified by calculating accident indices. human errors were assessed using risk assessment using Systematic human error reduction and prediction approach (SHERPA). Results: A total of 9 departments of a selected hospital were studied and the accident and human errors were identified. The recurrence rate of the accident in 2019 compared to 2018 had a decreasing rate from 11.36 to 4.09 (safe_T_score=-3.14). Risk assessment using SHERPA method in the gynecology ward revealed 4 important types of errors in this department. Conclusion: There was considerable reduction in frequency and severity of needle stick injuries after establishment of safety system in the hospital. The SHERPA method, detailed the task errors and specific remedial measure to correct the task. The results of this study can be helpful for medical staff, managers, employers, and safety experts in identifying and preventing the causes of the accident.
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