应关注患者安全事件中第二受害者的支持需求

患者安全问题是全球性的重要研究议题。在患者安全事件中的患者及其家属是第一受害者,可能受到伤害的医务人员（医生、护士、技师、药师等）可称为第二受害者。通过回顾国外第二受害者的研究现状,介绍第二受害者相关概念、流行程度、负面影响,面对患者安全事件带来负面影响时的应对策略以及支持需求。为国内患者安全研究提供借鉴与参考。     

UK dental students' ability and confidence in applying the Index of Orthodontic Treatment Need and determining appropriate orthodontic referral

Introduction

The aim was to assess the ability and confidence of UK undergraduate dental students in applying the Index of Orthodontic Treatment Need (IOTN) and determining appropriate orthodontic referral.

Materials and Methods

This was a cross-sectional survey using a case-based online questionnaire. Fourth and fifth year undergraduate dental students were recruited from UK dental schools through their university and social media. Six cases were presented and participants were asked to provide an IOTN score and judgement about referral. Participants were asked about their confidence, experience and orthodontic teaching.

Results

Sixty-nine responses were returned. A quarter of participants reported having used IOTN before in a clinical setting. Clinical experience with IOTN influenced confidence. Familiarity with making orthodontic referrals was low and only one participant reported having made an orthodontic referral. Correct IOTN scores were given by 68% of participants for a large 14 mm overjet (5a) case, 43% of participants for an impacted canine (5i) case and 26% of participants for an impacted premolar (5i) case. Incorrect IOTN was most common in hypodontia cases with only 19% correctly identifying mild hypodontia (4h) and 28% identifying severe hypodontia (5h). For the majority of cases, incorrect answers about referral were due to confusion between specialist practitioner and orthodontic consultant pathways.

Conclusions

Dental students' ability and confidence in correctly applying the IOTN Dental Health Component and selecting the appropriate referral pathway was inadequate. Responses suggest a lack of clinical experience in assessing patients, applying the IOTN and making referrals. The low response rate is disappointing and limits the scope for making recommendations.