Defining Patient Safety Events in Inpatient Psychiatry.
Defining Patient Safety Events in Inpatient Psychiatry.
复制标题
DOI：
10.1097/pts.0000000000000520
复制
发表时间：
2021-12-01
影响因子：
2.2
通讯作者：
Cullen SW
中科院分区：
文献类型：
--
作者：
Marcus SC;Hermann RC;Cullen SW
在过去的20年里，美国出现了一场改善医院医疗安全的全国性运动。然而，许多基础工作和后续研究都忽视了住院精神病学。本文的目的是通过IOM患者安全框架的应用，提出一种综合的方法来概念化住院精神病学中的患者安全。本文开发了一个框架，以表征医院为基础的精神卫生保健患者的安全。我们讨论了一些概念和方法上的问题，这些问题与定义住院精神病患者安全事件的构成有关，然后列举了在这种情况下发生的安全事件类型的一套全面的定义。住院精神病学中的患者安全事件大致分为不良事件和医疗差错。不良事件包括药物不良事件和非药物不良事件，包括自残或自伤、殴打、性接触、患者跌倒和其他伤害。医疗错误包括药物错误和非药物错误，如私奔和违禁品。我们已经制定了明确的定义，适用于住院精神健康治疗的流行病学研究。精神病学并不是国家安全运动的组成部分。作为打破这一鸿沟的第一步，我们已经考虑了精神病学事件如何符合大多数医学所采用的安全框架。患者安全应成为住院精神病学使命的关键部分，并作为研究和干预努力的主题严格追求。
The past 20 years have seen the emergence of a national movement to improve hospital-based healthcare safety in the United States. However, much of the foundational work and subsequent research have neglected inpatient psychiatry. The aim of this article was to advance a comprehensive approach for conceptualizing patient safety in inpatient psychiatry as framed by an application of the IOM patient safety framework. This article develops a framework for characterizing patient safety in hospital-based mental health care. We discuss some of the conceptual and methodological issues related to defining what constitutes a patient safety event in inpatient psychiatry then enumerate a comprehensive set of definitions of the types of safety events that occur in this setting. Patient safety events in inpatient psychiatry are broadly categorized as adverse events and medical errors. Adverse events are comprised of adverse drug events and non-drug adverse events, including self-harm or injury to self, assault, sexual contact, patient falls and other injuries. Medical errors include medication errors and non-medication errors, such as elopement and contraband. We have developed clear definitions that would be appropriate for use in epidemiological studies of inpatient mental health treatment. Psychiatry has not been an integral part of the national safety movement. As a first step toward breaching this chasm, we have considered how psychiatric events fit into the safety framework adopted across much of medicine. Patient safety should become a key part of inpatient psychiatry’s mission and pursued rigorously as the subject of research and intervention efforts.