危及患者安全:从一些重大事件中吸取的教训

P. L. Ariyananda
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引用次数: 0

摘要

在我近五十年的临床医生职业生涯中,我遇到过几个例子,我觉得我作为临床医生的角色是失败的。我认为这些重要的事件塑造了我的临床实践,并希望使我成为一个更好的临床医生。在本文中,我将讨论其中的一些情况,叙述我的经历,强调我认为我做错了什么,以及我们临床医生在这种情况下应该如何表现得最好。我将这篇论文分为以下几部分:历史研究的失误、体检的不完整、诊断的过早结束和治疗的不充分,每一项都将用我经历过的一个现实生活场景来说明。作为临床医生,我们应该努力实现零错误,但我们人类是不完美的,我们的行为和反应方式往往还有改进的余地。在你的临床实践中,无论你是否经历过重大事件,最好总是反思你本可以如何治疗你所见过的每一个病人,更好地使你的实践更具反思性,而不是以刻板的方式思考。
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Compromising patient safety: Lessons learnt from some critical incidents
During my professional career as a clinician for nearly five decades, I have come across several instances where I felt that my role as a clinician has been a failure. I consider these instances as critical incidents that have molded my clinical practice and hopefully made me a better clinician. In this paper, I will discuss about few of those situations, narrating the experience that I lived through, highlighting where I think I went wrong and how best we clinicians should perform under such circumstances. I have divided the paper into lapses in history taking, lack of completeness in physical examination, premature closure in making a diagnosis and inadequacies in treatment, and each of these will be illustrated using a real-life scenario that I have lived through. As clinicians, we should strive for zero error, but we human beings are imperfect and often have room for improvement in the ways we act and react. In your clinical practice, irrespective of whether you experience critical incidents or not, it is always better to reflect how you could have treated each patient you have seen, better and make your practice more reflective rather than thinking in a stereotyped manner.
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