Identification of Adverse Events in Inpatients: Results of a Preliminary Survey in Japan
Identification of Adverse Events in Inpatients: Results of a Preliminary Survey in Japan
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住院患者不良事件的识别：日本的初步调查结果
DOI：
10.7223/apjdm.4.49
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Hideto Sakai
中科院分区：
文献类型：
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作者：
S. Ikeda;Mia Kobayashi;Toshihiro Kaneko;M. Hirose;T. Hirao;Tomonori Hasegawa;T. Hasegawa;Hideto Sakai
探讨检测不良事件（ae）的可行性。对医疗记录的两阶段回顾性审查。在2002财政年度，从七家急症医院的住院病人（不包括精神病病房的病人）中随机挑选了700例出院病例。在审查的第一阶段，训练有素的护士审查人员使用18项筛选标准检查医疗记录，以确定潜在的不良事件。然后，一名护士主管对第一组护士审查员判定为阴性的所有病例进行复核，并在必要时纠正这些判断。在审查的第二阶段，医师审查小组确认发生，并对不良事件进行分类。在700例病例中，79例（11.3%）被判定为ae。79例中，26例因不良事件被纳入指标，53例在纳入指标时发生不良事件。21例的ae是高度可预防的。我们的判断与澳大利亚的调查结果一致。我们证实了两阶段评审过程检测AEs的可行性。为了提高日本医院的患者安全，有必要使用这种方法进行全国范围的调查，以充分了解ae的流行病学，包括ae的类型和促成因素。
To examine the feasibility of detecting adverse events (AEs). A two-stage retrospective review of medical records. Seven hundred cases discharged during fiscal year 2002 were randomly selected from among inpatients, excluding psychiatric ward patients, hospitalized at seven acute-care hospitals. In the first stage of the review, trained nurse reviewers examined the medical records using 18 screening criteria to identify potential AEs. A nurse supervisor then reviewed all the cases judged as being criteria-negative by the first set of nurse reviewers and corrected the judgements as necessary. During the second stage of the review, a physician review team confirmed the occurrence, and categorized the AEs. Of the 700 cases, 79 (11.3%) cases were judged to have had AEs. Of the 79 cases, the AEs were the reason for the index admission in 26 cases, and the AEs occurred during the index admission in 53 cases. It was also judged that the AEs were highly preventable in 21 cases. Our judgement was consistent with that in the Australian survey. We confirmed the feasibility of the two-stage review process to detect AEs. To improve patient safety in Japanese hospitals, a nationwide survey, using this methodology, is necessary to fully understand the epidemiology of AEs, including the types of AEs and the contributory factors.