Emergency Physician Perceptions of Patient Safety Risks
Emergency Physician Perceptions of Patient Safety Risks
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DOI：
10.1016/j.annemergmed.2009.08.020
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发表时间：
2010-04-01
影响因子：
6.2
通讯作者：
Cunningham, Ron
中科院分区：
文献类型：
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作者：
Sklar, David P.;Crandall, Cameron S.;Cunningham, Ron
研究目的：尽管存在解决患者安全性的国家标准，但其与急诊科（艾德）患者安全性的相关性尚不清楚。我们调查执业急诊医生，以评估他们的看法，病人的安全问题的相对重要性，以及如何这些不同的城市/农村的位置和实践characteristics.Methods：我们开发和分析电子收集的调查数据，评估急诊医生的看法，病人的安全风险。美国急诊医师学会（ACEP）成员用5分制的Likert量表对16名患者的安全问题进行了评分。结果：在2，507名急诊医师中，1，114名（44%）在城市执业，1，056名（42%）在郊区执业，337名（13%）在农村执业。住院病人的拥挤（平均李克特量表评分4.3），专科咨询的可用性（平均4.1）和护理短缺（平均3.9）是最大的问题。农村受访者将咨询师可用性（平均4.3）、艾德护理后缺乏随访（平均3.8）和护士短缺（平均3.8）列为首要问题。拥挤是郊区（平均4.3）和城市急诊医生（平均4.5）最关心的问题，但农村急诊医生（平均3.5）排名第七。拥挤被认为是一个更大的问题，因为医院的规模，艾德量，和病人谁离开而不被视为increased的百分比，无论实践location.Conclusion：在这个样本的执业急诊医生，农村急诊医生的病人的安全问题不同，他们的城市/郊区同行。对于城市/郊区急诊医生，拥挤是最大的安全问题;对于农村急诊医生，顾问可用性是最大的问题。急诊医生最关心的问题没有作为国家患者安全基准计划的一部分进行常规测量和报告。[Ann 2010;55：336-340.]
Study objective: Although national standards to address patient safety exist, their relevance to emergency department (ED) patient safety is unclear. We survey practicing emergency physicians to assess their perceptions of the relative importance of patient safety concerns and how these varied by urban/rural location and practice characteristics.Methods: We developed and analyzed electronically collected survey data that assessed emergency physician perceptions of patient safety risks. American College of Emergency Physicians (ACEP) members rated 16 patient safety concerns with a 5-point Likert scale.Results: Of 2,507 emergency physician respondents, 1,114 (44%) practiced in urban, 1,056 (42%) in suburban, and 337 (13%) in rural settings. Crowding from inpatient boarding (mean Likert scale score 4.3), availability of specialty consultation (mean 4.1), and nursing shortages (mean 3.9) were the greatest concerns. Rural respondents ranked consultant availability (mean 4.3), lack of follow-up after ED care (mean 3.8), and nurse shortages (mean 3.8) as top concerns. Crowding was the greatest concern for suburban (mean 4.3) and urban emergency physicians (mean 4.5) but was ranked seventh by rural emergency physicians (mean 3.5). Crowding was perceived as a greater problem as hospital size, ED volume, and the percentage of patients who left without being seen increased, regardless of practice location.Conclusion: In this sample of practicing emergency physicians, rural emergency physicians' patient safety concerns differ from those of their urban/suburban counterparts. For urban/suburban emergency physicians, crowding is the greatest safety concern; for rural emergency physicians, consultant availability was the greatest concern. Emergency physicians' greatest concerns are not routinely measured and reported as part of national patient safety benchmarking programs. [Ann Emerg Med. 2010;55:336-340.]