医疗安全不良事件发生原因与PDCA循环的应用效果  

Causes of Medical Safety Adverse Events and the Application Effect of PDCA Cycle

作　　者：陈雅婷[1] 胡曼娜 魏仁惠子 CHEN Yating;HU Manna;WEI Renhuizi(Quality Management Office,Dongguan Huangjiang Hospital,Dongguan Guangdong 523750,China)

机构地区：[1]东莞市黄江医院质量管理办公室,广东东莞523750

出　　处：《中国卫生标准管理》2024年第20期62-65,共4页China Health Standard Management

摘　　要：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。Objective To analyze the causes of adverse medical safety events and the application effect of plan-do-check-act(PDCA)cycle.Methods A total of 36459 patients were selected from various departments of the inpatient department of Dongguan Huangjiang Hospital from January 2021 to December 2022.Of these,a total of 18653 patients will be treated in 2021,routine medical safety management methods were used.A total of 17806 patients were treated in 2022,through analyzing the past adverse medical safety events in the inpatient department of Dongguan Huangjiang Hospital,and analyzing the causes of occurrence,the PDCA cycle management mode was applied to the medical safety management,and the application effect was observed.Results The incidence of medical and nursing adverse events and the total incidence of adverse events in 2022 were 1.40‰,4.72‰and 7.02‰,respectively,lower than 2.31‰,6.27‰and 9.70‰in 2021(P<0.05).The severity of adverse events in 2022 was better than that in 2021(P<0.05).The causes of adverse medical safety events in 2021 and 2022 were diagnosis and treatment issues,clinical management issues,and other aspects,the difference was not statistically significant(P>0.05).In 2022,the incidence of medical disputes was 0.34‰(6/17806)and the incidence of medical complaints was 1.40‰(25/17806),which were lower than 0.86‰(16/18653),2.36‰(44/18653)in 2021(P<0.05).Conclusion Applying the PDCA cycle to medical safety management is beneficial for reducing adverse medical safety events,reducing their severity,and reducing the incidence of medical disputes and complaints.

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 

分 类 号：R197[医药卫生—卫生事业管理]