Health Care Provider Factors Associated with Patient-Reported Adverse Events and Harm.
Health Care Provider Factors Associated with Patient-Reported Adverse Events and Harm.
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DOI：
10.1016/j.jcjq.2020.02.004
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发表时间：
2020-05
影响因子：
2.3
通讯作者：
Singh H
中科院分区：
文献类型：
--
作者：
Giardina TD;Royse KE;Khanna A;Haskell H;Hallisy J;Southwick F;Singh H
患者可以提供传统安全数据来源中缺失的有价值信息，并增加对导致可预防伤害的因素的见解。我们确定了患者报告的促成因素与他们在不良事件后经历的伤害之间的关联。我们分析了2010年1月至2016年2月期间通过在线问卷收集的患者报告不良事件的全国样本。我们使用广义logit多变量回归来评估自我报告的促成因素与自我报告的伤害之间的关联（分为无身体伤害、仅身体伤害、身体伤害和情感或经济伤害以及所有三种伤害），并根据患者和不良事件特征进行调整。在351例患者报告的身体、情感或经济伤害结局中，三分之一的患者（32.6%）报告经历了所有三种伤害，27.3%报告了身体伤害和一种额外伤害，25.5%仅报告了身体伤害，14.7%仅报告了非身体伤害。报告所有三种伤害的患者向负责机构提交不良事件报告的可能性高2.5倍（95% CI：1.23-5.01），发生手术并发症的可能性高3.3倍（95% CI：1.42-7.51）。在经历所有三种伤害类型的患者中，报告与临床医生和患者/家属之间的沟通或临床医生相关行为问题相关的问题的几率高出13%（95% CI：1.07-1.19）。患者的经验对于识别安全性问题和减少伤害非常重要，应将其纳入患者安全性测量和改进活动中。我们的研究结果强调了需要新的政策和实践举措来识别，解决和支持受伤害的患者。
Patients can provide valuable information missing from traditional sources of safety data and add insights on factors that lead to preventable harm. We determined associations between patient-reported contributory factors and harms they experienced after an adverse event. We analyzed a national sample of patient-reported adverse events gathered through an online questionnaire between January 2010 and February 2016. We used generalized logit multivariable regression to assess the association between self-reported contributory factors and self-reported harms (grouped as no physical harm, physical harm only, physical harm and emotional or financial harm, and all three harms) and adjusted for patient and adverse event characteristics. In 351 patient reports with outcomes of physical, emotional, or financial harms, one-third of patients (32.6%) reported experiencing all three harms, 27.3% reported physical harms and one additional harm, 25.5% reported physical harms only, and 14.7% reported only non-physical harms. Patients who reported all three harms were 2.5 times more likely to have filed a report of their adverse event with a responsible authority (95% CI:1.23–5.01) and 3.3 times more likely to have also experienced a surgical complication (95% CI:1.42–7.51). The odds of reporting problems related to communication between clinician and patients/families or clinician-related behavioral issues was 13% higher in those experiencing all three harm types (95% CI:1.07–1.19). Patients’ experiences are important to identify safety issues and reduce harm and should be included in patient safety measurement and improvement activities. Our findings underscore the need for new policy and practice initiatives to identify, address, and support harmed patients.
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影响因子：
9.7
作者：
Giardina, Traber Davis;Haskell, Helen;Singh, Hardeep
通讯作者：
Singh, Hardeep
影响因子：
--
作者：
Dovey, SM;Meyers, DS;Grob, P
通讯作者：
Grob, P
影响因子：
9.7
作者：
Giardina, Traber Davis;King, Beth J.;Singh, Hardeep
通讯作者：
Singh, Hardeep
影响因子：
2.4
作者：
Kok J;Leistikow I;Bal R
通讯作者：
Bal R
影响因子：
--
作者：
Bland, JM;Altman, DG
通讯作者：
Altman, DG