使用触发工具衡量新医院患者安全的整体发展情况。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES International Journal for Quality in Health Care Pub Date : 2024-07-19 DOI:10.1093/intqhc/mzae064
Ivan Adamovic, Peter Dahlem, Johannes Brachmann
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引用次数: 0

摘要

背景:德国利希滕费尔斯医院的新大楼于 2018 年 7 月中旬投入使用。医务人员和医疗部门均未发生变化。我们希望评估新医院或新科室在初期的 "安全 "或 "不安全 "程度。我们的目的是调查,尽管环境和条件都很现代化,但新医院在成立之初的安全性是否会降低:方法:纳入与治疗相关的不良事件,以评估医疗护理和药物导致的不良事件总数。患者的病历必须是完整的,住院时间至少为 24 小时,必须是正式入院(美国医疗保健改进研究所 IHI GTT "全球触发工具 "建议)。已确认的不良事件被归入医疗保健改进研究所 "全球触发工具 "的 27 个类别。我们每月随机审查 40 份患者病历,分别在搬到新医院前 6 个月和搬到新医院后 6 个月进行审查:统计分析显示,单个不良事件没有明显差异。迁入新医院后,不良事件的总和在统计学上较高。不良事件总数在统计学上具有显著性(χ2=6.62;df=1;p):根据我们的研究结果,新医院在成立后的第一阶段(6 个月)稍显不安全。
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Measuring the overall development of patient safety in a new hospital using trigger tools.

The new building of the Hospital in Lichtenfels (Germany) was put into operation in mid-July 2018. Neither the medical personnel nor medical departments have been changed. We want to evaluate how 'safe' or 'insecure' the new hospital or department in the beginning might have been. Our objective is to investigate if safety decreases at the beginning in a new hospital, despite modern environments and conditions. Adverse events (AEs) associated with treatment were included to evaluate the total number of AEs resulting from medical care and medications. Patients' records had to be closed and completed, the length of stay had to be at least 24 h, and the patient had to have been formally admitted to the hospital [Institute for Healthcare Improvement (IHI) 'Global Trigger Tool' (GTT) recommendation]. The identified AEs were grouped into 27 categories of the IHI 'GTT'. We randomly reviewed 40 patient records per month 6 months before and 6 months after moving to the new hospital. Statistical analysis showed that there was no significant difference in individual AEs. The sum of AEs was statistically higher after moving into a new hospital. A complete number of harms did reach statistical significance (χ2 = 6.62; df = 1; P < .05; Cramer's V = 0.12), indicating that new environments 'trigger' significantly more potential errors (50%) in comparison to the old environments (38.33%). According to our findings, the new hospital appears to be slightly insecure in the first 6 months after opening.

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来源期刊
CiteScore
4.90
自引率
3.80%
发文量
87
审稿时长
6-12 weeks
期刊介绍: The International Journal for Quality in Health Care makes activities and research related to quality and safety in health care available to a worldwide readership. The Journal publishes papers in all disciplines related to the quality and safety of health care, including health services research, health care evaluation, technology assessment, health economics, utilization review, cost containment, and nursing care research, as well as clinical research related to quality of care. This peer-reviewed journal is truly interdisciplinary and includes contributions from representatives of all health professions such as doctors, nurses, quality assurance professionals, managers, politicians, social workers, and therapists, as well as researchers from health-related backgrounds.
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