Out-of-Hospital Pediatric Patient Safety Events: Results of the CSI Chart Review.
Out-of-Hospital Pediatric Patient Safety Events: Results of the CSI Chart Review.
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DOI：
10.1080/10903127.2017.1371261
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发表时间：
2018-05
影响因子：
2.4
通讯作者：
Guise JM
中科院分区：
文献类型：
--
作者：
Meckler G;Hansen M;Lambert W;O'Brien K;Dickinson C;Dickinson K;Van Otterloo J;Guise JM
目的：对成人医院患者的研究已确定医疗错误是发病率和死亡率的重要原因。人们对院外儿童患者安全事件的频率和性质知之甚少。我们试图量化 EMS 中的儿科患者安全事件，并确定与潜在严重事件相关的患者、呼叫和护理特征。方法：作为儿童安全倡议 -EMS 的一部分，专家小组独立审查了大都市区三年内儿科危重救护车运输的图表。回归模型用于识别与潜在严重安全事件风险增加相关的因素。患者安全事件被分类为： 意外伤害；有惊无险；行动不理想；错误;评估了管理并发症（“UNSEM”）及其严重性和潜在可预防性。结果：总体而言，378 个独特图表中的 265 个（70.1%）包含至少一个 UNSEM，其中包括 146 个（32.8%）错误和 199 个（44.7%）次优操作。 61 个 UNSEM 被归类为潜在严重疾病（占 UNSEM 的 23.3%），近一半 (45.3%) 被评为完全可以预防。有两个因素与严重 UNSEM 风险增加相关：(1) 年龄 29 天至 11 个月（OR 3.3，95% CI 1.25-8.68）； (2) 需要复苏的病例（OR 3.1，95% CI 1.16-8.28）。心肺骤停中严重 UNSEM 的比例异常高（病例数为 8.5%，严重 UNSEM 为 34.4%）。结论：在儿科患者的高风险院外护理期间，安全事件很常见，可能很严重，而且基本上是可以预防的。婴儿和需要复苏的患者是减少院外儿科患者安全事件的重要关注领域。
Objective: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events.Methods: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period. Regression models were used to identify factors associated with increased risk of potentially severe safety events. Patient safety events were categorized as: Unintended injury; Near miss; Suboptimal action; Error; or Management complication (“UNSEMs”) and their severity and potential preventability were assessed.Results: Overall, 265 of 378 (70.1%) unique charts contained at least one UNSEM, including 146 (32.8%) errors and 199 (44.7%) suboptimal actions. Sixty-one UNSEMs were categorized as potentially severe (23.3% of UNSEMs) and nearly half (45.3%) were rated entirely preventable. Two factors were associated with heightened risk for a severe UNSEM: (1) age 29 days to 11 months (OR 3.3, 95% CI 1.25-8.68); (2) cases requiring resuscitation (OR 3.1, 95% CI 1.16-8.28). Severe UNSEMs were disproportionately higher among cardiopulmonary arrests (8.5% of cases, 34.4% of severe UNSEMs).Conclusions: During high-risk out-of-hospital care of pediatric patients, safety events are common, potentially severe, and largely preventable. Infants and those requiring resuscitation are important areas of focus to reduce out-of-hospital pediatric patient safety events.
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影响因子：
2.4
作者：
Hansen M;Meckler G;Dickinson C;Dickenson K;Jui J;Lambert W;Guise JM
通讯作者：
Guise JM
DOI：
10.1080/10903129808958841
发表时间：
1998-01-01
期刊：
Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
影响因子：
--
作者：
Gausche, M;Henderson, D P;Foltin, G L
通讯作者：
Foltin, G L
影响因子：
5.9
作者：
Becker, LR;Zaloshnja, E;Miller, TR
通讯作者：
Miller, TR
影响因子：
2.4
作者：
Cottrell EK;O'Brien K;Curry M;Meckler GD;Engle PP;Jui J;Summers C;Lambert W;Guise JM
通讯作者：
Guise JM
影响因子：
38.9
作者：
Hatherill, M;Waggie, Z;Argent, A
通讯作者：
Argent, A