从瑞典医疗机构与医疗信息技术相关的事故报告中找出与患者细节相关的挑战。

IF 3.2 Q1 HEALTH CARE SCIENCES & SERVICES Frontiers in digital health Pub Date : 2024-02-06 eCollection Date: 2024-01-01 DOI:10.3389/fdgth.2024.1260521
Md Shafiqur Rahman Jabin, Ding Pan, Evalill Nilsson
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引用次数: 0

摘要

导言:尽管医疗信息技术(HIT)系统带来了许多好处,但如果规划、设计、实施和管理不当,新技术也会给医疗质量和患者安全带来新的、不可预见的风险。本研究对与医疗信息技术(HIT)相关的事件进行了调查,以确定与患者细节相关的问题、其与诱因的关联以及结果:信息来源包括使用两种抽样方法(即有目的抽样和滚雪球抽样)回顾性收集的事故报告(n = 95)。采用归纳法(专题分析)和演绎法(即现有的患者安全国际分类框架)对事件报告进行分析:研究发现,90 起事故中有 120 个与患者细节相关的问题,这些问题被归类为信息相关问题(48%)或文件相关问题(52%);120 个问题中约有三分之二是人为因素造成的。在所有样本中,确定了 87 个促成因素,其中 "医疗设备/系统"(45%)和 "文档"(20%)是最常见的促成因素。在 90 起事故中,一半以上(59%)是与患者相关的结果--患者不便(47%)和患者伤害(12%),其余 41%(n = 37)是与员工或组织相关的结果:讨论:一半以上的事件导致了与患者相关的结果,即患者不便和患者伤害,包括疾病风险、严重健康恶化、受伤甚至患者死亡。与患者细节相关的事件可能会造成有害影响;因此,对这些事件进行定性应成为临床实践的常规部分,以改善不断变化的医疗保健系统。
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Characterizing patient details-related challenges from health information technology-related incident reports from Swedish healthcare.

Introduction: Despite many benefits offered by Health Information Technology (HIT) systems, new technology brings new and unforeseen risks to healthcare quality and patient safety if they're not properly planned, designed, implemented, and managed. This study examined health information technology-related (HIT) incidents to identify patient details-related issues, their association with contributing factors, and outcomes.

Methods: Sources of information comprised retrospectively collected incident reports (n = 95) using two sampling methods, i.e., purposive and snowball sampling. The incident reports were analyzed using both the inductive method (thematic analysis) and the deductive approach using an existing framework, i.e., the International Classification for Patient Safety.

Results: The studies identified 90 incidents with 120 patient details-related issues-categorized as either information-related (48%) or documentation-related (52%) problems; around two-thirds of the 120 issues were characterized by human factors. Of the total sample, 87 contributing factors were identified, of which "medical device/system" (45%) and "documentation" (20%) were the most common contributing factors. Of 90 incidents, more than half (59%) comprised patient-related outcomes-patient inconvenience (47%) and patient harm (12%) and the remaining 41% (n = 37) included staff or organization-related outcomes.

Discussion: More than half of the incidents resulted in patient-related outcomes, namely patient inconvenience and patient harm, including disease risks, severe health deterioration, injury, and even patient death. Incidents associated with patient details can cause deleterious effects; therefore, characterizing them should be a routine part of clinical practice to improve the constantly changing healthcare system.

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