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Application of traditional indexes and adverse events in the ophthalmologic perioperative medical quality evaluation during 2010-2012 被引量:1
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作者 Yong-Na Bian Jian Shi +2 位作者 Jun-Jun She Jie Wu Jian-Min Gao 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2015年第5期1051-1055,共5页
AIM: To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital. METHODS: The relevant data of perioperative period were collected in our hospital during 2010-2012, and the... AIM: To evaluate the medical quality of ophthalmologic perioperative period during 2010-2012 in our hospital. METHODS: The relevant data of perioperative period were collected in our hospital during 2010-2012, and the medical quality of perioperative period was evaluated by using the traditional evaluation indexes and adverse events. Whereby, the traditional indicators include vision changes, improving of intraocular pressure, diagnostic accordance rate before and after operation, cure improvement rate, successful rescue rate, and incidence of surgical complications, etc Adverse events are associated with ophthalmologic perioperative events including pressure sores, postoperative wound infection, drug adverse events, and equipment related adverse events. RESULTS: There were 1483, 1662 and 1931 ophthalmic operations in our hospital in the year 2010, 2011 and 2012, respectively. From traditional index analysis, the proportions of vision improvement for each year were 96.43%, 96.76% and 97.32%, respectively; the rates of intraocular pressure improvement were 87.50%, 85.72% and 90.17%, respectively ( P <0.05); the diagnostic accordance rates before and after operation were 99.86%, 99.94% and 99.90%, respectively; cure improvement rates were 99.73%, 99.93% and 99.84%, respectively; the successful rescue rates were 82.98%, 81.46% and 76.66%, respectively; the complications incidence rates were 18.44%, 17.52% and 17.97%, respectively. The negative factor analysis results showed that: among all the patients of ophthalmic surgeries in our hospital during 2010 and 2012, only one case of postoperative wound infection was found in 2011, and also only one case of tumbling in 2010. The adverse drug events for each year were 1 case (0.07%), 2 cases (0.12%), and 4 cases (0.21%), respectively; the medical device adverse events for each year were 3 cases (0.20%), 5 cases (0.30%), and 6 cases (0.31%), respectively. Noticeably, only one case with postoperative infection of endophthalmitis was found in 2011. Moreover, no pulmonary infection or pulmonary embolism occurred during the three years. The perioperative adverse event rates for each year were 0.34% (5/1483), 0.48% (8/1662) and 0.52% (10/1931), respectively. Though incidence was rising during the three years, no statistical significance was observed (P>0.05). It is the same case with drugs and medical devices adverse events (P>0.05). CONCLUSION: Traditional indicators reflect an excellent operation of the perioperative ophthalmologic quality, whereas adverse events analysis indicates some underlying problems. Compared with the traditional indexes for medical quality evaluation, the index of adverse events is more reasonable and easier to make an objective evaluation for medical quality of ophthalmologic perioperation, facilitating further refine analysis. Reasonable application of the adverse events indicators helps hospital to make the detailed quality control measures. 展开更多
关键词 perioperative period medical quality evaluation index adverse events OPHTHALMOLOGY
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Evidence-based expert consensus on clinical management of safety of Bruton’s tyrosine kinase inhibitors(2024)
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作者 Zaiwei Song Dan Jiang +19 位作者 Lingling Yu Yixuan Chen Daobin Zhou Yue Li Depei Wu Lingli Zhang Liyan Miao Jun Ma Jun Zhu Hongmei Jing Rongsheng Zhao the Steering Committee,the Consensus Panel and the Evidence Synthesis Group Evidence-based Pharmacy Professional Committee of Chinese Pharmaceutical Association(CPA) Hospital Pharmacy Professional Committee of Chinese Pharmaceutical Association(CPA) Division of Therapeutic Drug Monitoring of Chinese Pharmacological Society(CPS) Expert Committee on Lymphoma of Chinese Society of Clinical Oncology(CSCO) Expert Committee on Leukemia of Chinese Society of Clinical Oncology(CSCO) Society of Integrative Cardio-Oncology of China Anti-Cancer Association(CACA) Chinese Society of Hematology of Chinese Medical Association(CMA) Hospital Pharmacy Professional Committee of Cross-Straits Medicine Exchange Association(SMEA) 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2024年第3期240-256,共17页
Bruton’s tyrosine kinase inhibitors(BTKis)have revolutionized the treatment of B-cell lymphomas.However,safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy.A... Bruton’s tyrosine kinase inhibitors(BTKis)have revolutionized the treatment of B-cell lymphomas.However,safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy.A comprehensive and systematic expert consensus from a pharmacological perspective is lacking for safety issues associated with BTKi treatment.A multidisciplinary consensus working group was established,comprising 35 members from the fields of hematology,cardiovascular disease,cardio-oncology,clinical pharmacy,and evidencebased medicine.This evidence-based expert consensus was formulated using an evidence-based approach and the Delphi method.The Joanna Briggs Institute Critical Appraisal(JBI)tool and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach were used to rate the quality of evidence and grade the strength of recommendations,respectively.This consensus provides practical recommendations for BTKis medication based on nine aspects within three domains,including the management of common adverse drug events such as bleeding,cardiovascular events,and hematological toxicity,as well as the management of drug-drug interactions and guidance for special populations.This multidisciplinary expert consensus could contribute to promoting a multi-dimensional,comprehensive and standardized management of BTKis. 展开更多
关键词 CONSENSUS BTK inhibitors safety adverse drug events drug-drug interactions
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Patient Safety,Adverse Healthcare Events and Near-Misses in Obstetric Care—A Systematic Literature Review 被引量:2
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作者 Elisabeth Severinsson Megumi Haruna +1 位作者 Maria Ronnerhag Ingela Berggren 《Open Journal of Nursing》 2015年第12期1110-1122,共13页
Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses ... Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals’ perspectives on ethical conflicts, attributing blame and responsibility, and patients’ perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge about the risk of AEs and the use of best practice guidelines are also essential. 展开更多
关键词 Maternal Care adverse Obstetric Healthcare events Patient safety Near-Misses
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Why Don’t We Adequately Identify and Manage Adverse Drug Reactions despite Having the Needed Information?
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作者 Mark J. Kupersmith Karl Kieburtz 《Health》 2024年第2期148-159,共12页
Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digit... Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs. 展开更多
关键词 adverse Drug Reaction Medication Side Effect Identification Medication Complication Medication safety
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Proprotein convertase subtilisin/kexin type 9 inhibitors in peripheral artery disease:A review of efficacy,safety,and outcomes
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作者 Moiud Mohyeldin Ahmed S Abuelgasim Ahmed MG Mustafa 《World Journal of Cardiology》 2024年第7期397-401,共5页
Peripheral artery disease(PAD)is a common condition characterized by atherosclerosis in the peripheral arteries,associated with concomitant coronary and cerebrovascular diseases.Proprotein convertase subtilisin/kexin ... Peripheral artery disease(PAD)is a common condition characterized by atherosclerosis in the peripheral arteries,associated with concomitant coronary and cerebrovascular diseases.Proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors are a class of drugs that have shown potential in hypercholesterolemic patients.This review focuses on the efficacy,safety,and clinical outcomes of PCSK9 inhibitors in PAD based on the literature indexed by PubMed.Trials such as FOURIER and ODYSSEY demonstrate the efficacy of evolocumab and alirocumab in reducing cardiovascular events,offering a potential treatment option for PAD patients.Safety evaluations from trials show few adverse events,most of which are injection-site reactions,indicating the overall safety profile of PCSK9 inhibitors.Clinical outcomes show a reduction in cardiovascular events,ischemic strokes,and major adverse limb events.However,despite these positive findings,PCSK9 inhibitors are still underutilized in clinical practice,possibly due to a lack of awareness among care providers and cost concerns.Further research is needed to establish the long-term effects and cost-effectiveness of PCSK9 inhibitors in PAD patients. 展开更多
关键词 Peripheral artery disease Proprotein convertase subtilisin/kexin type 9 inhibitors Cardiovascular risk reduction Evolocumab Alirocumab Lipid-lowering therapy Major adverse limb events Clinical outcomes COST-EFFECTIVENESS safety profile
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Nursing-related Patient Safety Events in Hospitals 被引量:2
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作者 刘义兰 赵光红 +5 位作者 李芬 黄行芝 胡德英 许娟 姚尚龙 张亮 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2009年第2期265-268,共4页
To explore the method of identifying nursing-related patient safety events, types, contributing factors and evaluate consequences of these events in hospitals of China, incident report program was established and impl... To explore the method of identifying nursing-related patient safety events, types, contributing factors and evaluate consequences of these events in hospitals of China, incident report program was established and implemented in 15 patient units in two teaching hospitals of China to get the relevant information. Among 2935 hospitalized patients, 141 nursing-related patient safety events were reported by nurses. Theses events were categorized into 15 types. Various factors contributed to the events and the consequence varied from no harm to patient death. Most of the events were pre- ventable. It is concluded that incident reporting can provide more information about patient safety, and establishment of a program of voluntary incident reporting in hospitals of China is not only urgent but also feasible. 展开更多
关键词 patient safety nursing error adverse events incident report
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Critical values of monitoring indexes for perioperative major adverse cardiac events in elderly patients with biliary diseases
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作者 Zong-Ming Zhang Xi-Yuan Xie +9 位作者 Yue Zhao Chong Zhang Zhuo Liu Li-Min Liu Ming-Wen Zhu Bai-Jiang Wan Hai Deng Kun Tian Zhen-Tian Guo Xi-Zhe Zhao 《World Journal of Clinical Cases》 SCIE 2022年第20期6865-6875,共11页
BACKGROUND Major adverse cardiac events(MACE) in elderly patients with biliary diseases are the main cause of perioperative accidental death, but no widely recognized quantitative monitoring index of perioperative car... BACKGROUND Major adverse cardiac events(MACE) in elderly patients with biliary diseases are the main cause of perioperative accidental death, but no widely recognized quantitative monitoring index of perioperative cardiac function so far.AIM To investigate the critical values of monitoring indexes for perioperative MACE in elderly patients with biliary diseases.METHODS The clinical data of 208 elderly patients with biliary diseases in our hospital from May 2016 to April 2021 were retrospectively analysed. According to whether MACE occurred during the perioperative period, they were divided into the MACE group and the non-MACE group.RESULTS In the MACE compared with the non-MACE group, postoperative complications, mortality, hospital stay, high sensitivity troponin-Ⅰ(Hs-TnI), creatine kinase isoenzyme(CK-MB), myoglobin(MYO), B-type natriuretic peptide(BNP), and Ddimer(D-D) levels were significantly increased(P < 0.05). Multivariate logistic regression showed that postoperative BNP and D-D were independent risk factors for perioperative MACE, and their cut-off values in the receiver operating characteristic(ROC) curve were 382.65 pg/mL and 0.965 mg/L, respectively.CONCLUSION The postoperative BNP and D-D were independent risk factors for perioperative MACE, with the critical values of 382.65 pg/mL and 0.965 mg/L respectively. Consequently, timely monitoring and effective maintenance of perioperative cardiac function stability are of great clinical significance to further improve the perioperative safety of elderly patients with biliary diseases. 展开更多
关键词 Biliary diseases in elderly patients Major adverse cardiac events Perioperative safety Logistic regression Receiver operating characteristic curve
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重组人生长激素临床应用的安全性思考 被引量:1
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作者 潘慧 杜红伟 《中国当代儿科杂志》 CAS CSCD 北大核心 2024年第5期444-449,共6页
重组人生长激素(recombinant human growth hormone,rhGH)是改善身材矮小的有效治疗药物,目前rhGH可应用于包含生长激素缺乏症在内的多种原因导致的身材矮小,临床应用的扩展使其安全性问题备受关注。基于现有证据,当rhGH规范应用于生理... 重组人生长激素(recombinant human growth hormone,rhGH)是改善身材矮小的有效治疗药物,目前rhGH可应用于包含生长激素缺乏症在内的多种原因导致的身材矮小,临床应用的扩展使其安全性问题备受关注。基于现有证据,当rhGH规范应用于生理性替代治疗时,其安全性较好。临床中,应用rhGH进行治疗期间可结合文献证据和临床经验重点关注短期安全性,长期安全性由于rhGH治疗时间不足尚无准确定论。该文梳理了在rhGH治疗过程中有可能出现的不良事件及其风险控制措施,旨在帮助临床医生了解rhGH治疗的整体安全性,改善临床规范化应用。 展开更多
关键词 重组人生长激素 临床安全性 不良事件 风险控制
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Observation on the Application Effect of Targeted Infusion Safety Nursing in Inpatients with Cancer
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作者 Xue Jin Wenfeng Li 《Journal of Clinical and Nursing Research》 2023年第4期38-44,共7页
Objective:To study the clinical effect of targeted infusion safety nursing during infusion of inpatients with cancer.Methods:From January 1,2020,to January 1,2023,a total of 6,614 infusion patients were treated in The... Objective:To study the clinical effect of targeted infusion safety nursing during infusion of inpatients with cancer.Methods:From January 1,2020,to January 1,2023,a total of 6,614 infusion patients were treated in The First Affiliated Hospital of Wenzhou Medical University,and 300 inpatients with cancer were selected as the research objects and randomly divided into the observation group and the control group,with 150 patients in each group.The control group received routine infusion nursing,and the observation group received targeted infusion safety nursing.The targeted infusion safety nursing was judged by comparing the nursing quality assessment,incidence of adverse events,patient compliance,and patients’mastery of infusion knowledge between the two groups.clinical effect.Results:After the targeted infusion safety nursing was given to the patients in the observation group,the patients in this group recognized the nursing quality,and the statistical score was higher than that in the control group;the incidence of adverse events in the observation group was lower than that in the control group.The compliance of the observation group was higher than that of the control group.The mastery of health knowledge in the observation group was also higher than that in the control group and the difference was statistically significant(P<0.02).Conclusion:After implementing targeted infusion safety nursing for inpatients with cancer,it can effectively prevent the occurrence of adverse events,improve patient compliance,and increase the mastery of relevant knowledge of patients. 展开更多
关键词 Tumor patients Infusion nursing Targeted safety nursing adverse events
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基于美欧医疗器械上市后法规要求对我国建立医疗器械警戒制度的思考 被引量:1
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作者 李尧 卞蓉蓉 +6 位作者 焦灵利 李明 宋雅娜 郑立佳 李栋 赵一飞 赵燕 《中国食品药品监管》 2024年第2期94-103,共10页
本文旨在深入探讨美国和欧盟的医疗器械上市后监管制度,包括风险监管理念、监管法规体系、上市后临床研究、质量管理体系等,总结出开发风险监测工具、落实风险管理、采用合并报告模式、公开风险信息等经验,为我国医疗器械行业有序发展... 本文旨在深入探讨美国和欧盟的医疗器械上市后监管制度,包括风险监管理念、监管法规体系、上市后临床研究、质量管理体系等,总结出开发风险监测工具、落实风险管理、采用合并报告模式、公开风险信息等经验,为我国医疗器械行业有序发展提供参考。我国可以借鉴美欧医疗器械上市后的监管实践,从提高监管机构能力、建设监测哨点和强化法规框架等方面,建立和试点医疗器械警戒制度。 展开更多
关键词 医疗器械 警戒制度 不良事件监测 风险 试点
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基于FAERS的哌拉西林他唑巴坦不良事件信号挖掘与分析
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作者 刘金伟 董俊丽 +1 位作者 邵钰 张韶辉 《中国药师》 CAS 2024年第7期1231-1239,共9页
目的挖掘哌拉西林他唑巴坦(TZP)的药品不良事件(ADE)信号,促进临床合理、安全用药。方法采用比例失衡法对美国食品药品管理局不良事件报告系统(FAERS)自建库至2024年3月所有TZP ADE报告进行信号挖掘,分析报告病例的基本情况及不良反应... 目的挖掘哌拉西林他唑巴坦(TZP)的药品不良事件(ADE)信号,促进临床合理、安全用药。方法采用比例失衡法对美国食品药品管理局不良事件报告系统(FAERS)自建库至2024年3月所有TZP ADE报告进行信号挖掘,分析报告病例的基本情况及不良反应相关信息。结果共提取得到主要怀疑药物涉及ADE报告数为20620513条,TZP为主要怀疑药物涉及ADE报告数为6489条。共挖掘ADE信号543个,涉及25个器官/系统分类(SOC),二次筛选最终检测出ADE信号数43个,其中新的ADE信号17个,ADE信号涉及SOC分类的数量排名前5为分别是皮肤及皮下组织类疾病、全身性疾病及给药部位各种反应、各类检查、感染及侵染类疾病、血液及淋巴系统疾病;ADE信号数排名前5位的首选术语分别为皮疹、发热、急性肾损伤、瘙痒、血小板减少症。青霉素类药物在血液及淋巴系统疾病存在多种不良反应信号,TZP导致血小板减少病例数最多,苯唑西林导致粒细胞缺乏关联强度比例报告比值比最高;TZP导致白细胞减少疗程中位数为11.00 d,累积剂量中位数为148.50 g;该药导致粒细胞缺乏疗程中位数为14.00 d,累积剂量中位数为216.00 g;该药导致血小板减少症疗程中位数为7.00d,累积剂量中位数为87.00 g。结论用药期间需密切关注皮肤及皮下组织类疾病相关不良反应,可能较胃肠道系统疾病更多;临床大剂量或长疗程应用TZP时可导致多个系统发生不良反应,尤其需密切关注血液及淋巴系统疾病相关不良反应,避免发生严重不良反应。 展开更多
关键词 哌拉西林他唑巴坦 药物不良事件 FAERS数据库 信号挖掘 血液及淋巴系统疾病 用药安全
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某大型综合医院2021—2023年医疗器械不良事件监测及报告分析
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作者 张哲 李源 +2 位作者 杨栋 霍永胜 胡晓媛 《中国医疗设备》 2024年第10期104-110,共7页
目的通过分析某大型综合医院2021—2023年医疗器械不良事件(Medical Device Adverse Event,MDAE)监测情况,为医疗机构在医疗器械安全使用和不良事件监测工作中提供参考和借鉴。方法采用回顾性分析方法,统计分析该院1082例MDAE报告的报... 目的通过分析某大型综合医院2021—2023年医疗器械不良事件(Medical Device Adverse Event,MDAE)监测情况,为医疗机构在医疗器械安全使用和不良事件监测工作中提供参考和借鉴。方法采用回顾性分析方法,统计分析该院1082例MDAE报告的报告年份、报告天数、审核结果和涉及的医疗器械名称、产地、管理类别、产品类别、产品分类等情况。结果该院近3年上报的MDAE总数和通过率逐年递增,平均报告天数呈下降趋势(P<0.001)。990例有效报告中,国产、Ⅱ类、无源医疗器械的不良事件例数高于进口、Ⅰ类和Ⅲ类、有源和体外诊断试剂(P<0.001);14-注输、护理和防护器械类的不良事件报告最多(P<0.05),以一次性器械断裂、变形或污染和输液泵、注射泵故障为主要不良表现;03-神经和心血管手术器械造成的严重伤害例数最多(P<0.001),主要为导丝和球囊的断裂、变形导致术中植入失败。结论开展采购、入库到临床使用的全流程追溯,将MDAE监测上报纳入科室目标考核,可加强临床科室和医疗器械管理人员联动,提升医疗机构MDAE监测效能。 展开更多
关键词 医疗器械 不良事件 严重伤害 监测 全流程追溯 医疗器械故障
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阿达木单抗药品不良反应文献分析
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作者 张裴 许良 +1 位作者 李晓雨 沈静 《中国药业》 CAS 2024年第14期124-128,I0001,共6页
目的 为临床合理使用阿达木单抗提供参考。方法 检索中国知网(CNKI)、万方(WanFang)、维普(VIP)、PubMed数据库,获得以阿达木单抗为首要怀疑药物的中英文文献。检索时限为各数据库自建库起至2022年12月。收集患者的基本信息及阿达木单... 目的 为临床合理使用阿达木单抗提供参考。方法 检索中国知网(CNKI)、万方(WanFang)、维普(VIP)、PubMed数据库,获得以阿达木单抗为首要怀疑药物的中英文文献。检索时限为各数据库自建库起至2022年12月。收集患者的基本信息及阿达木单抗药品不良反应(ADR)相关信息,进行分类统计与分析。结果 共检索到文献283篇,筛选后得相关文献101篇,涉及患者101例。其中男56例(55.45%),女45例(44.55%);年龄8~82岁,平均(45.39±17.32)岁,以> 40~60岁居多(47例);来自美国的患者最多(16例),我国与英国并列第4(9例);原患疾病以克罗恩病居多(22例,21.78%);主要累及皮肤及其附件(40例,39.60%),最多见的临床表现为药疹(14例,13.86%);ADR严重程度以中度最多(64例,63.37%);关联性评价结果以很可能最多(79例,78.22%);联合用药21例(20.79%),包括二联用药18例,三联用药2例,四联用药1例;疗程以8周最多见;73例经停药和(或)药物治疗(包括对症支持治疗、换药或改变用药剂量等)后症状治愈或好转,但仍有2例经上述处理后死亡。结论 临床医师在应用阿达木单抗时应准确把握用药指征,严格按药品说明书用药,并熟悉其ADR常见类型和发生时间,加强ADR监测,确保用药安全。 展开更多
关键词 阿达木单抗 药品不良反应 文献分析 用药安全 药学监护
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选择不同对照疫苗对疑似预防接种异常反应信号检测的影响
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作者 夏兰芳 李克莉 +2 位作者 王磊 李燕 王华庆 《中国药物警戒》 2024年第7期798-804,810,共8页
目的探索不同类型疫苗做对照时的信号检出情况,为疑似预防接种异常反应(AEFI)信号检测中选择适宜对照疫苗提供参考。方法分别选择所有其他疫苗和同技术路线其他疫苗做对照,对所有疫苗和特定疫苗进行信号检测,汇总所有其他疫苗和同技术... 目的探索不同类型疫苗做对照时的信号检出情况,为疑似预防接种异常反应(AEFI)信号检测中选择适宜对照疫苗提供参考。方法分别选择所有其他疫苗和同技术路线其他疫苗做对照,对所有疫苗和特定疫苗进行信号检测,汇总所有其他疫苗和同技术路线其他疫苗做对照时信号检出数量,相同信号、新出现信号和消失信号个数及其反应分类分布,检测灵敏度和特异度。结果与所有其他疫苗做对照时相比,同技术路线其他疫苗做对照时,各种类疫苗信号检出个数均明显减少,全部信号检出数从501个减少至254个;新出现信号35个,新出现信号比例最大的是多糖疫苗,为24.39%(10/41),反应分类为一般反应(10个)、异常反应(3个)、偶合症(2个);消失信号282个,消失信号比例最大的是重组蛋白疫苗,为94.92%(56/59),消失信号的反应分类为偶合症(53个)、异常反应(23个)、一般反应(13个)。同技术路线其他疫苗做对照时,检测一般反应和异常反应的灵敏度降低,特异度增加,但减毒活疫苗和多糖疫苗中检测一般反应的灵敏度增加。结论不同类型疫苗做对照时,检出信号数差异较大;同技术路线其他疫苗做对照时,可以增加一般反应中信号的检出数量,但可能会造成较多异常反应信号消失。建议对于较严重的异常反应进行检测时,使用所有其他疫苗做对照。 展开更多
关键词 疑似预防接种异常反应 疫苗安全 信号检测 对照 灵敏度 特异 技术路线
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PDCA循环管理在提高床均医疗质量安全不良事件上报例数中的应用效果
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作者 林晓云 包浔娜 +2 位作者 庄海虹 罗梓菁 陈金妙 《中国卫生标准管理》 2024年第8期70-73,共4页
目的根据等级医院评审和三级公立医院绩效考核的要求,研究计划-实施-检查-处理(Plan-Do-Check-Action,PDCA)循环管理在提高床均医疗质量安全不良事件上报例数中的应用效果。方法选取广东省农垦中心医院2021年1—12月床均医疗质量安全不... 目的根据等级医院评审和三级公立医院绩效考核的要求,研究计划-实施-检查-处理(Plan-Do-Check-Action,PDCA)循环管理在提高床均医疗质量安全不良事件上报例数中的应用效果。方法选取广东省农垦中心医院2021年1—12月床均医疗质量安全不良事件上报例数进行现状分析,并制定改进措施,持续监测;再选取2022年1—12月的床均医疗质量安全不良事件报告情况,通过对比改进前后验证PDCA循环法的作用效果。结果2022年1—12月医疗质量安全不良事件上报例数为887例,季度床均医疗质量安全不良事件报告例数分别为:第一季度15.5例,第二季度21.0例,第三季度19.4例,第四季度32.8例。2021—2022年床均医疗质量安全不良事件上报例数呈上升趋势。2022年1—12月医院不良事件上报例数高于2021年1—12月,差异有统计学意义(P<0.05)。结论运用PDCA循环的管理思路能有效提高床均医疗质量安全不良事件上报例数,加强医疗安全,提高服务质量。 展开更多
关键词 PDCA循环管理 床均医疗质量 安全不良事件 上报例数 医疗安全 服务质量
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基于福格行为模型的社区主要不良心脏事件高危者的健康干预
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作者 李红 邹继华 +5 位作者 黎晓艳 郑晶琎 陈飞燕 刘翀 高井全 陶然 《护理学杂志》 CSCD 北大核心 2024年第19期6-10,共5页
目的探讨基于福格行为模型的健康干预对社区主要不良心脏事件高危者生活方式、用药依从性及院前延迟行为意向的影响。方法将不良心脏事件高危者按照社区分为对照组和干预组各66人。对照组采用常规健康管理,干预组在对照组的基础上依据... 目的探讨基于福格行为模型的健康干预对社区主要不良心脏事件高危者生活方式、用药依从性及院前延迟行为意向的影响。方法将不良心脏事件高危者按照社区分为对照组和干预组各66人。对照组采用常规健康管理,干预组在对照组的基础上依据福格行为模型从动机、能力和提示3个关键要素进行健康干预6个月并随访3个月。在干预前、干预后和随访后对两组健康促进生活方式、院前延迟行为意向、用药依从性进行评价。结果对照组60人、干预组57人完成干预及随访。干预及随访后,干预组健康促进生活方式、用药依从性评分显著高于对照组,院前延迟行为意向评分显著低于对照组(均P<0.05)。结论基于福格行为模型的健康干预有利于提高社区不良心脏事件高危者的健康促进生活方式和用药依从性,降低院前延迟行为意向。 展开更多
关键词 主要不良心脏事件 高危人群 福格行为模型 健康干预 健康促进生活方式 院前延迟 就医行为意向 服药依从性
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基于患者360视图的护理不良事件管理系统构建与应用
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作者 孙萌 骆金铠 +2 位作者 王露露 李宏洁 毛文平 《中国卫生质量管理》 2024年第4期54-58,共5页
目的构建基于患者360视图的护理不良事件管理系统,优化护理不良事件管理流程。方法护理不良事件管理系统包含可视化安全预警、向导式上报及反馈追踪、分层系统培训3个功能模块,于2021年1月正式应用。结果系统应用后,压力性损伤、给药错... 目的构建基于患者360视图的护理不良事件管理系统,优化护理不良事件管理流程。方法护理不良事件管理系统包含可视化安全预警、向导式上报及反馈追踪、分层系统培训3个功能模块,于2021年1月正式应用。结果系统应用后,压力性损伤、给药错误以及不良事件整体发生率均较应用前下降,其中给药错误发生率差异具有统计学意义(P<0.05),而管路滑脱、跌倒/坠床的发生率较应用前略有增加;护理不良事件整改达标率由92.8%提高至95.7%(P<0.05);组织科护士长培训12次,组织全院护士长专项培训20余次,开展护理质量安全管理标准化操作规程工作坊12场次。结论基于患者360视图的护理不良事件管理系统可以提高护理风险识别率,降低护理不良事件发生率。下一步需在充分考虑患者特点与需求的基础上进一步优化系统功能。 展开更多
关键词 360视图 护理不良事件 患者安全 质量与信息化
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医疗安全不良事件发生原因与PDCA循环的应用效果
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作者 陈雅婷 胡曼娜 魏仁惠子 《中国卫生标准管理》 2024年第20期62-65,共4页
目的分析医疗安全不良事件发生原因并观察计划-实施-检查-处理(plan-do-check-act,PDCA)循环的应用效果。方法选择2021年1月—2022年12月东莞市黄江医院住院部各个科室收治的36459例患者。其中2021年收治18653例患者,采用常规的医疗安... 目的分析医疗安全不良事件发生原因并观察计划-实施-检查-处理(plan-do-check-act,PDCA)循环的应用效果。方法选择2021年1月—2022年12月东莞市黄江医院住院部各个科室收治的36459例患者。其中2021年收治18653例患者,采用常规的医疗安全管理方法;2022年收治17806例患者,通过分析过往东莞市黄江医院住院部医疗安全不良事件,并且分析发生的原因,然后把PDCA循环管理模式应用于医疗安全管理中,观察其应用效果。结果2022年医疗类、护理类不良事件发生率以及不良事件总发生率分别为1.40‰、4.72‰、7.02‰,低于2021年的2.31‰、6.27‰、9.70‰(P<0.05);2022年不良事件严重程度优于2021年(P<0.05)。2021年与2022年发生医疗安全不良事件的原因均为诊疗问题、临床管理问题、其他方面,差异无统计学意义(P>0.05)。2022年医疗纠纷发生率为0.34‰(6/17806),医疗投诉发生率为1.40‰(25/17806),低于2021年的0.86‰(16/18653)、2.36‰(44/18653)(P<0.05)。结论PDCA循环模式应用于医疗安全管理有利于减少医疗安全不良事件,减轻其严重程度,并且降低医疗纠纷发生率和医疗投诉发生率。 展开更多
关键词 医疗安全不良事件 发生原因 PDCA循环 医疗纠纷 医疗投诉 医疗管理
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高州市2023-2024年疑似预防接种异常反应监测分析
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作者 江进权 陈晓玲 +3 位作者 周剑 陈智婷 梁莉蓉 吴思敏 《中国卫生产业》 2024年第13期218-222,共5页
目的探究分析高州市2023—2024年疑似预防接种异常反应(adverse events following immunization,AEFI)监测结果。方法通过中国疾病预防控制信息系统检索收集2023年1月—2024年3月期间的预防接种AEFI监测报告数据,对AEFI监测结果予以描... 目的探究分析高州市2023—2024年疑似预防接种异常反应(adverse events following immunization,AEFI)监测结果。方法通过中国疾病预防控制信息系统检索收集2023年1月—2024年3月期间的预防接种AEFI监测报告数据,对AEFI监测结果予以描述性分析。结果2023年1月—2024年3月高州市接种疫苗出现245例AFEI,平均每年报告发生率为15.22/10万剂次。一般反应占比80.00%(196/245)、异常反应占比10.61%(26/245),未出现接种事故以及疫苗质量事故。AFEI个案中男女性别比例为1.36∶1;以<1岁者发生AEFI最多,10~15岁者发生AEFI最少。接种至出现症状的间隔时间以<1 d发生AEFI最多。AFEI报告涉及疫苗36种,前三位是百白破疫苗(无细胞)、麻腮风疫苗、13价肺炎疫苗;报告发生率前三位是带状疱疹疫苗(CHO细胞)、ACYW135流脑疫苗(结合)、冻干甲肝减毒活疫苗;引起一般反应的疫苗前两位是带状疱疹疫苗(CHO细胞)、ACYW135流脑疫苗(结合);引起异常反应的疫苗前两位是麻腮风疫苗、23价肺炎球菌疫苗。结论2023年1月—2024年3月高州市AEFI监测结果符合监测要求,且能在一定程度上说明预防接种疫苗的安全性,但需关注AFEI报告中发生率较高的疫苗,并需加强高州市AEFI监测,提升AEFI监测的及时性与灵敏度。 展开更多
关键词 疑似预防接种异常反应 监测 异常反应发生率 疫苗安全性
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391名医务人员对医疗安全不良事件报告意向的现状调查
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作者 陈旭 胡海 吴昊 《中国老年保健医学》 2024年第5期61-65,共5页
目的调查并了解北京某三级中医医院医务人员对医疗安全(不良)事件报告意向、报告认知及报告障碍的现状,为医院的医疗安全培训方案及管理体系研究提供参考依据。方法采用简单随机抽样的方法,于2024年6月使用自制问卷对北京某三级中医医... 目的调查并了解北京某三级中医医院医务人员对医疗安全(不良)事件报告意向、报告认知及报告障碍的现状,为医院的医疗安全培训方案及管理体系研究提供参考依据。方法采用简单随机抽样的方法,于2024年6月使用自制问卷对北京某三级中医医院医务人员进行线上调查。结果共391名医务人员参与调查,其中医生120名(30.69%)、护士164名(41.94%)、医技人员27名(6.91%)、药剂人员46名(11.76%)、职能行政人员14名(3.58%)、后勤人员20名(5.12%)。调查对象对严重程度较高的不良事件报告意向率较高,但对没有造成伤害、潜在漏洞的不良事件报告意向率较低;调查对象对不良事件报告认知的制度、培训认知度较好,但实际“填写过不良事件报告表”占比较低;不同年龄、性别、人员类别、学历、职称调查对象的报告意向、认知和障碍的总分差异有显著统计学意义;报告意向与报告认知之间有正相关关系,与报告障碍之间有负相关关系。结论医院医务人员不良事件报告意向及认知有待提升,下一步将完善构建医院的医疗安全不良事件管理体系,提升全员不良事件报告责任意识,努力构建全流程、全方位的不良事件管理氛围。 展开更多
关键词 不良事件 报告意向 报告认知 报告障碍 医务人员
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