根本原因分析法在医疗安全不良事件分析中的应用

Application of root cause analysis method in the analysis on adverse events of medical safety

目的探讨我院医疗安全不良事件发生的原因及对策,以保障患者安全,提高医院管理水平。方法采用根本原因分析法对住院患者跌倒损伤和门诊患者取药差错不良事件发生的原因进行分析,并针对原因提出对策,进行整改。结果经整改后,我院患者跌倒引发损伤类不良事件发生率持续降低,从4.6%降至1.1%,门诊患者取药差错事件的发生率由8.2%降至1.6%。结论根本原因分析法在预防医疗安全不良事件中成效明显,对于医院规范管理具有一定应用意义。

Objective The paper aims to discuss the causes of and countermeasures for the adverse events of medical safety in the Hospital so as to guarantee the safety of patients and elevate the management level of the Hospital. Method The root cause analysis method is employed to analyze the causes of adverse events, such as fall injuries of inpatients and mistaken medicine-taking of outpatients, and countermeasures are proposed for rectification. Result After the rectification, the incidence of adverse events of inpatients＇ fall injuries in the Hospital is continuously decreased from 4.6% to 1.1% and that of the events of outpatients＇ mistaken medicine-taking from 8.2% to 1.6%. Conclusion The root cause analysis method has an obvious effect on the prevention of adverse events of medical safety and certain application significance to the standardization of hospital management.