患者为患者安全伦敦宣言

我们,患者为患者安全,希望实现一个无因医疗过失而受害的世界,我们作为合作伙伴,保护人们不受卫生保健中本可避免的伤害。风险与不确定性始终相伴。因此,我们走到一起进行对话,与医护人员一起参加卫生保健。我们将通力合作,倡导在发展中国家和发达国家消除卫生保健工作中发生的伤害。     

参与 WHO"患者为患者安全"活动,做一个明智的患者

在公众中倡导“患者为患者安全”活动有助于患者和医疗服务提供者创建和提供安全可靠、极具人性化的卫生保健体系和优质服务,有助于促进卫生保健体系真正实现“以患者为中心”。本文简述“患者为患者安全”项目的基本目的、内容和意义,探讨患者如何参与患者安全项目,帮助医疗服务提供者共同杜绝和避免医疗过失。     

患者为患者安全策略会议 2010年1月25—27日在日内瓦举行

患者为患者安全（Patients for Patient Safety,PFPS）策略会议2010年1月25-27日在日内瓦举行,PFPS指导委员会成员,11位PFPS带头人和包括WHO秘书处工作人员在内的许多其他人员参加了会议。中国循证医学中心张呜明教授作为WHO西太平洋地区PFPS带头人应邀参会。     

患者参与患者安全质量评价指标体系的构建

目的 构建患者参与患者安全（Patients for Patient Safety,PFPS）质量评价指标体系,以期为患者参与身安全工作的实施与管理提供借鉴。方法 采用文献研究法、专家小组讨论法、德尔菲法及百分权重法筛选指标并定指标权重,确立PFPS质量评价指标体系。结果 两轮问卷的回收率分别为88.46%、84.62%,专家权威系分别为0.870、0.858。两轮咨询后,各级指标的变异系数为0～0.213,协调系数W为0.429,最终形成的PFPS质量评价指标体系包含一级指标6个,二级指标9个,三级指标26个。结论 PFPS质量评价指标体系制订方法可靠,可操作性强,为评价医院患者参与自身安全工作提供了科学的测评工具。     

WHO患者参与患者安全工作会2010年1月25～27日在瑞士日内瓦召开

“患者为患者安全”（Patients for Patient Safety,PPS）项目是WHO世界患者安全联盟倡导的患者安全的六个行动纲领之一,旨在代表患者心声,建立患者和患者安全倡导者及卫生用户参与的国际网络,倡导患者安全,协助卫生保健从业者减少和避免危害患者健康的一切医疗过失。     

首届患者安全国家级继续教育培训项目

2010年12月6-9日在广州举行患者安全培训项目于2010年12月6-9日在广州暨南大学第一临床医学院举行,此次培训内容以WHO患者安全培训课程的理论和方法为基础。100余人     

住院患者心理安全行为现状及其与感知参与的相关性研究

目的探讨住院患者心理安全行为现状及其与感知参与的相关性。方法采用便利抽样法, 选取2021年6月—2022年1月山东省烟台市2所二级医院和2所三级医院收治的900例住院患者为研究对象。采用一般资料调查表、住院患者心理行为安全问卷、患者感知参与量表对患者进行调查。采用Pearson相关性分析探讨住院患者心理安全行为与感知参与的相关性。采用分层回归分析探讨住院患者心理安全行为的影响因素。本研究共发放问卷900份, 回收有效问卷886份, 问卷的有效回收率为98.44%(886/900)。结果 886例住院患者的心理行为安全问卷总分为(98.97±16.52)分, 条目均分为(2.91±0.38)分;患者感知参与量表总分为(36.59±4.91)分, 条目均分为(2.81±0.35)分。Pearson相关性分析结果显示, 住院患者心理行为安全问卷总分与患者感知参与量表总分之间呈负相关(r=-0.358, P<0.01)。分层回归分析结果显示, 感知参与是住院患者心理安全行为的影响因素, 可独立解释住院患者心理安全行为变异的25.6%。结论住院患者的心理安全行为处于中等水平, 感知参与是...     

患者参与患者安全的系统评价

目的系统评价国内外患者参与患者安全的相关研究,并与我国患者参与患者安全的研究现状进行比较,为如何在我国开展患者参与患者安全教育,改进医疗质量提供循证决策建议。方法电子检索MEDLINE、EMbase、CBM,并追索纳入文献的参考文献,根据预先制定的纳入和排除标准筛选文献、提取数据,采用Cochrane Handbook 5.0和Critical Appraisal Skills Programme评价标准分析文献质量,采用定性研究方法综合分析资料。结果共纳入28篇文献,其中中文5篇,除1篇为随机对照试验外,其余均为横断面研究。定量或定性结果显示:①患者对患者安全的认知度国内外都普遍贫乏,但患者参与患者安全的意愿较为强烈;②患者参与的影响因素包括特征、疾病、情感;③3篇文献分别从感染、医疗差错、用药方面分析了患者的参与方式;④患者参与能有效促进医务人员规范操作,预防不安全事件发生,减少伤害;⑤所纳入的5篇中文文献的研究内容仅涉及患者对患者安全的认识、参与态度及影响因素。结论目前关于患者参与患者安全的研究尚少,更缺乏高质量的随机对照试验验证患者参与方式的有效性,提示今后的研究应加强患者参与患者安全后效果的评价。     

患者参与患者安全策略的研究现状

通过对患者参与患者安全的研究背景、对象及意义、理论支持、意愿研究、患者参与患者安全的策略研究的探讨,提出了患者参与患者安全未来的发展方向,为使患者真正参与医疗卫生服务提供参考。     

加强薄弱环节管理提高老年患者护理质量

目的加强薄弱环节管理,提高老年患者护理服务质量。．方法查找老年患者护理管理的薄弱环节有重点时段（重大节假日,双休日、早中晚时间段,危重患者抢救、出入院患者周转高峰期,治疗护理工作量大、护士人数减少的时段）;重点患者（危重、长期卧床、行动不便、静脉输液、手术及留置各种管道等易发生安全问题的患者）;重点护士（基本功不够扎实、服务意识不够强的护理人员）;重点环节（指交接班、医嘱执行和查对、患者特殊用药及治疗护理操作等环节）。针对这些薄弱环节制定有效的管理措施：按照工作量和患者情况合理调配人力资源,实行弹性排班;在重点时段和重点环节增加查房次数,加大检查指导力度;组织对重点患者进行安全评估,加强护理安全管理;加强基础护理质量管理。结果2006年在危重患者数量增加、护理人员不增加的情况下,基础护理质量合格率、操作考试达标率、患者满意度均较上年同期提高;不安全事件的发生数量减少。结论加强薄弱环节管理,有利于减少护理风险,提高老年患者护理服务质量。     

甲亢病人的心率变异性及临床意义

目的 :通过对 31例甲状腺机能亢进症 (简称甲亢 )患者 (甲亢组 )和 31例正常人 (对照组 )的心率变异性 (HRV)的分析 ,进一步了解甲亢患者自主神经功能状况。方法 :对甲亢组和对照组进行 2 4hHRV对比分析。结果 :甲亢组与对照组比较其时域指标 :SDNN、SDANN明显降低 ,频域指标 :VLF、LF/HF增高 (P <0 .0 0 1,P <0 .0 5 ) ,LF、HF降低 ,与对照组有显著差异 (P<0 .0 0 1,P <0 .0 5 )。结论 :通过HRV的变化 ,进一步说明甲亢患者的交感神经受损和迷走神经失衡。     

Audit for a Purpose

This article argues that to be successful clinical audit needs to have an explicit and useful purpose. This is for the general purpose of audit, and for each specific clinical audit project. Negative and positive views about clinical audit are compared with the official policy that the purpose of clinical audit is to improve patient care. It is suggested that to be purposeful, each clinical audit project needs to be clearly focused and concern issues that are important to the people who are going to carry out the audit. The audit also needs to address issues about quality, such as effectiveness and efficiency. It is also suggested that clinicians need to own the audit process if they are to be committed to examining their own practice and identifying any deficiencies. The choice of audit topic and analysis of data should therefore be controlled by the clinicians. This leads to discussion of possible conflict between managers, purchasing agencies and clinicians over the choice of audit topics. It is concluded that careful negotiation may be required to ensure that each audit topic is perceived as purposeful by clinicians.     

Efficacy of a Patient Education Session for Cancer Patients Receiving Immunotherapy

ObjectivesOur research questions include: What are gaps in cancer patients’ knowledge about immunotherapy? What is the efficacy of an education session in improving cancer patients’ knowledge about immunotherapy and reducing inappropriate emergency department (ED) visits?Data SourcesFrom July 2020 to September 2021, we invited cancer patients receiving immunotherapy to participate in a one-on-one patient education session and pre-test/post-test surveys. The patient education session included an oral presentation following National Comprehensive Cancer Network guidelines, video on immunotherapy mechanisms of action, and review of written materials and alert cards. The surveys assessed patient knowledge of immunotherapies’ mechanisms of action, adverse effects and their management, and health literacy. Survey data were paired with data abstracted from the electronic health record on patient ED utilization and demographic characteristics.ConclusionBefore the education session, knowledge gaps about immunotherapy included understanding the medical term “itis,” side effects of immunotherapy, and treatment for side effects of immunotherapy. Overall, the education session significantly improved cancer patients’ knowledge about immunotherapy. The education session addressed knowledge gaps by significantly increasing patients’ knowledge of immunotherapy mechanisms of action, recognition of side effects, and ability to define the medical term “itis”. Because our sample had low inappropriate ED utilization, we could not assess the impact of the education session on inappropriate ED utilization.Implications for Nursing PracticeA multicomponent strategy for patient education was effective in improving overall knowledge uptake, especially among patients who initially had the least knowledge. Future studies should continue to explore whether patient education decreases inappropriate ED utilization.     

The Effect of Emergency Department Crowding on Patient Satisfaction for Admitted Patients

Objectives: The objective was to study the association between factors related to emergency department (ED) crowding and patient satisfaction. Methods: The authors performed a retrospective cohort study of all patients admitted through the ED who completed Press‐Ganey patient satisfaction surveys over a 2‐year period at a single academic center. Ordinal and binary logistic regression was used to study the association between validated ED crowding factors (such as hallway placement, waiting times, and boarding times) and patient satisfaction with both ED care and assessment of satisfaction with the overall hospitalization. Results: A total of 1,501 hospitalizations for 1,469 patients were studied. ED hallway use was broadly predictive of a lower likelihood of recommending the ED to others, lower overall ED satisfaction, and lower overall satisfaction with the hospitalization (p < 0.05). Prolonged ED boarding times and prolonged treatment times were also predictive of lower ED satisfaction and lower satisfaction with the overall hospitalization (p < 0.05). Measures of ED crowding and ED waiting times predicted ED satisfaction (p < 0.05), but were not predictive of satisfaction with the overall hospitalization. Conclusions: A poor ED service experience as measured by ED hallway use and prolonged boarding time after admission are adversely associated with ED satisfaction and predict lower satisfaction with the entire hospitalization. Efforts to decrease ED boarding and crowding might improve patient satisfaction.