北京市某三甲医院“提前介入”谈话的现状调查  

Investigation on Current Status of “Early Intervention” Conversation of One Class A Tertiary Hospital in Beijing

作　　者：宋涵超 胥雪冬[1] 周利平[1] 庹琳[1] 周洪柱[1] SONG Hanchao;XU Xuedong;ZHOU Liping;TUO Lin;ZHOU Hongzhu(Department of Medical Affairs,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院医务处,北京100191

出　　处：《中国医学伦理学》2018年第9期1148-1151,1169,共5页Chinese Medical Ethics

摘　　要：目的调查某医院"提前介入"谈话的现状与存在问题,探讨改进方法。方法调取该医院2014-2016年"提前介入"谈话记录、纠纷投诉记录、查阅谈话患者病历,进行描述性统计分析,对谈话情况进行现场调查。结果该医院单一科室谈话例数多于多科室联合谈话、术前谈话例数多于非术前谈话、谈话后行手术治疗患者多于放弃手术治疗患者、行3级或4级手术治疗的谈话患者人数最多、术后进入ICU监护治疗的患者多于不进入ICU监护治疗的患者,该院妇产科、骨科发生医疗纠纷投诉的例数较多,谈话医生对病情与治疗情况沟通较多、对替代治疗方法、术后恢复、人文关怀等内容沟通较少。结论 "提前介入"谈话提高医患双方风险意识、保障患者权利,提高医疗安全质量、防止医疗差错的发生。Objective： To investigate the current status and problems of ＂early intervention＂conversation in a hospital,and explore ways for improvement. Methods： The ＂early intervention ＂conversation records,dispute complaint records,and consultation of patients＇ medical records from 2014 to 2016 years in the hospital were taken for descriptive statistical analysis. On-site survey on the status of conversations was conducted. Results：In the hospital,the number of conversations conducted in single department was more than that conducted in multiple departments; the number of pre-operative conversations was more than non-preoperative conversations. Patients undergoing surgery after preoperative conversation were more than those giving up surgery;the number of patients who conducted conversations with level 3 or level 4 surgeries was the most;patients entering ICU after surgery were more than those who did not. There were more numbers of complaints in the obstetrics and gynecology,and orthopedics departments of the hospital. Doctors who conducted conversations with patients talked more about patient＇s condition and treatment,but less communication about alternative treatments,postoperative recovery and humanistic care. Conclusion：＂Early intervention＂conversation can enhance the risk awareness of both doctors and patients,guarantee patient＇s rights,improve the quality of medical safety and prevent the occurrence of medical errors.

关 键 词：提前介入 术前谈话 医疗纠纷 医患沟通 人文关怀 

分 类 号：R195[医药卫生—卫生统计学]