法国COVID-19健康危机期间的患者安全事件:一项探索性顺序多方法研究

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL European Journal of General Practice Pub Date : 2021-12-01 DOI:10.1080/13814788.2021.1945029
Jean-Pascal Fournier, Jean-Baptiste Amélineau, Sandrine Hild, Jérôme Nguyen-Soenen, Anaïs Daviot, Benoit Simonneau, Paul Bowie, Liam Donaldson, Andrew Carson-Stevens
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引用次数: 11

摘要

背景:2019冠状病毒病大流行导致卫生和社会保健服务迅速重组。患者已经面临与医疗保健相关的重大伤害风险,大流行期间服务提供的大规模中断将加剧这些风险。目的:探讨法国初级保健机构在COVID-19第一波期间患者安全事件的类型和性质,提出初步改进建议。方法:于2020年4月28日向法国全科医生(gp)分发了一份全国患者安全事件报告调查。报告采用与世卫组织国际患者安全分类(事件类型、促成因素、事件结果和伤害严重程度)相一致的分类系统进行编码。分析涉及数据编码、处理、使用描述性统计分析迭代生成数据摘要。Clinicaltrials.gov: NCT04346121。结果:132例事件中,58例(44%)与延迟诊断、评估和转诊有关。这些事件中有22起(17%)报告了取消预约、住院或手术。与家庭监禁有关的事件报告有13起(10%),停止使用不当药物的报告有5起(4%)。26例(10%)患者因担心在就诊时感染COVID-19而推迟就诊或未咨询全科医生或其他医疗保健提供者,8例(3%)患者因担心给全科医生增加负担。结论:来自第一波COVID-19大流行的制约因素导致了非COVID-19护理期间的患者安全事件。这些事件的教训指出,法国的初级保健服务可以在哪些方面集中资源,为患者设计更安全的系统。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Patient-safety incidents during COVID-19 health crisis in France: An exploratory sequential multi-method study in primary care.

Background: The COVID-19 pandemic has resulted in the rapid reorganisation of health and social care services. Patients are already at significant risk of healthcare-associated harm and the wholesale disruption to service delivery during the pandemic stood to heighten those risks.

Objectives: We explored the type and nature of patient safety incidents in French primary care settings during the COVID-19 first wave to make tentative recommendations for improvement.

Methods: A national patient safety incident reporting survey was distributed to General Practitioners (GPs) in France on 28 April 2020. Reports were coded using a classification system aligned to the WHO International Classification for Patient Safety (incident types, contributing factors, incident outcomes and severity of harm). Analysis involved data coding, processing, iterative generation of data summaries using descriptive statistical analysis. Clinicaltrials.gov: NCT04346121.

Results: Of 132 incidents, 58 (44%) related to delayed diagnosis, assessments and referrals. Cancellations of appointments, hospitalisations or procedures was reported in 22 (17%) of these incidents. Home confinement-related incidents accounted for 13 (10%) reports and inappropriate medication stopping for five (4%). Patients delayed attending or did not consult their general practitioner or other healthcare providers due to their fear of contracting COVID-19 infection at an in-person visit in 26 (10%) incidents or fear of burdening their GPs in eight (3%) incidents.

Conclusion: Constraints from the first wave of the COVID-19 pandemic have contributed to patient safety incidents during non-COVID-19 care. Lessons from these incidents pinpoint where primary care services in France can focus resources to design safer systems for patients.

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来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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