Objective To systematically review the abroad studies on patients for patient safety, and compare them with the current status of domestic studies, so as to provide suggestions for evidence-based strategic decision about how to conduct the education of patients for patient safety and improve the medical quality. Methods The databases of MEDLINE, EMbase and Chinese Biomedical Literature Database (CBM) were searched to identify the relevant studies and their references. Literatures were screened with data extraction in accordance with the predefined inclusive and exclusive criteria. The quality of literatures was assessed with the standard of Cochrane Handbook 5.0 and Critical Appraisal Skills Programme, and the data were comprehensively analyzed with qualitative research methods.Results Among 28 included studies, 5 were Chinese literatures, 1 was RCT, and the others were cross-sectional studies. The results showed that: a) Generally, the patients at home and abroad were poor in the awareness of patient safety, but they were eager to participate in the patient safety; b) Factors affecting patients’ participation were their characteristics, disease-related, and emotional feelings; c) Three studies reported the methods of involving patients in patient safety from the aspects of infection, malpractice, and medication; d) Some studies showed that patients’ participation could effectively promote the standardized operation of medical staffs, prevent unsafe events, and reduce damages; and e) The research contents of the included Chinese literatures were just related to the patients’ awareness of patient safety, attitude to participation, and influencing factors. Conclusion The limited studies relevant to patients for patient safety are short of high-quality RCTs for proving the effectiveness of patient participation methods, so it indicates that the stress should be laid on evaluating the effectiveness of patients for patient safety in future research.
Objective To provide information for the establishment of a medical risk monitoring and precaution system in China, by reviewing and analyzing the current status of medical risk management system and preventative measures in New Zealand, Methods We searched EI (1969-2006), SCI and SSCI (1975-2006), EMBASE (1966-2006), SCOPUS (included 100% MEDLINE) (1960-2006), VIP (1989-2006), CNKI (1979-2006) and relevant official and governmental websites. This search was conducted in January 2006 and articles about medical risk management and prevention were collected. Results We included 10 articles involving medical adverse events, patient safety and medical litigation. New Zealand took many measures in order to prevent medical error and improve medical quality, including strengthening medical practice standards, doctor-patient communication, safety awareness and promoting informationization of hospitals. New Zealand also revised “The Health Practitioners Competence Assurance Act” and improved medical litigation to form an appropriate law environment. Conclusions New Zealand has taken many measures and established a medical risk management system to prevent medical risk. Some issues of particular relevance to China include building corresponding medical litigation and relevant laws and regulations.
Objective To evaluate evidence from American medical risk monitoring and precaution system (AMRMPS) which may affect the construction of Chinese medical risk monitoring and precaution system (CMRMPS). Methods We searched relevant databases and Internet resources to identify literature on AMRMPS, medical errors, and patient safety. We used the quality evaluation system for medical risk management literature to extract and evaluate data. Results In 1999, a report from the Institute of Medicine (IOM) not only showed the severity and cause of medical errors in America but also gave the solution of it. In 2000, the Quality Interagency Coordination Task Force (QuIC) was appointed to assess the IOM report and take specific steps to improve AMRMPS. After 5 years, a well-developed medical risk management system was established with the improvement in the public awareness of medical errors, patient safety, performance criteria of medical safety, information technology and error reporting system. There was still some weakness of this system in risk precaution and prevention. Conclusion The experience from AMRMPS can be used to establish the CMRMPS. Firstly, we should disseminate and strengthen the awareness of medical risk and patient safety in public. Secondly, we should establish hospital audit system which includes auditing of medical staff and course of medical risk in continuing and academic education. Thirdly, we should develop regulations and guidelines on health care, medical purchase and drug supply which will benefit in management of regular work. Fourthly, we should develop computer information system for hospital which will regulate the management without the disturbance from human. Lastly, we should emphasize outcome evaluations and strive for perfection during the process.
This paper introduces the current situation of patient safety movement in 20 years from its origin, and expounds the strategies of patient safety from six view points of medical reform, medical insurance, system, culture, education and training, and patient participation in patient safety, so as to promote the healthy development of patient safety work in China.
This article introduced the structure and features of the medical safety and quality management system of New South Wales (NSW) of Australia. The system was funded by government with overall design, multi-sectors involvement, and explicit roles of government, hospitals, and independent third parties. The system also developed national and state-wide regulations, policies, standards and their certification. The NSW Health Incident Information Management System (IIMS), the guidelines and interventional programs were also established to decrease the medical risk and ensure the healthcare quality. This system will be used for reference to the national medical risk and quality management system of China.
Objective To analyze experiences of medical risk management in the United Kingdom so as to explore the possible application for the construction of a Chinese medical risk monitoring and early warning system. Methods We searched Engineering Information, SCI and SSCI, EMBASE, SCOPUS with 100% MEDLINE, VIP, CNKI, and government or official websites. This search was conducted in Jan. 2006. We included articles about medical risk, patient safety and medical errors in the UK. Languages of articles were limited either in English or in Chinese. Results Eleven articles were included, of which 9 article are evidence of level B (about 80%) and the other 2 are evidence of level C (about 20%). The report of “An Organization with a Memory” revealed the severity of medical errors and adverse events in the UK in 2000, and subsequently Minister Blair announced a five-year reform program for NHS. Within 7 years of reform, NHS budget has been increased from £33 billion to £674 billion,(check numbers-doesn’t sound correct) the National Patient Safety Agency (NPSA) and the New National System for learning from adverse events and near misses have been established, a series of practicable measures aimed at ensuring patient safety, preventing medical risk and improving healthcare quality have been implemented, all of which have effectively resolved many problems that perplexed the government and public, such as patients waiting time, range of NHS service, the availability of medical facility and mortality induced by high-risk diseases. Conclusion There are both advantages and disadvantages in the present status of the UK medical risk management. Both of them will provide a guide to prevent medical risk, improve healthcare quality and to realize the ultimate goal that everybody could share healthcare sources fairly and safely in our country.
To attend the Patient Safety Summit of UK Presidency of the EU 2005, learn and share ideas with each other, participate in discussing and developing the vision and mission as well as goals for patients for patient safety program, seek the common interest for further cooperation so as to help promote the activities on patient safety in healthcare in China.
Objective To learn and analyse the current clinicians’ knowledge and attitudes towards patient safety, and to provide relevant evidence for future medical education. Method We conducted a survey on clinicians mainly in West China Hospital of Sichuan University with group random sampling method. We analysed the data on the clinicians’ knowledge and attitudes with SPSS softerware. Result Totally 300 questionnaires were distributed, of which 258 were completed adequately. The results showed the clinicians’ knowledge on patient safety was poor, however, the respcnse from the clinicians in Outpatient Department were better than those in Inpatient Department. The majority of the clinicians (above 95.00%) were willing to learn the knowledge of patient safety. Conclusion As the clinicians are willing to learn the knowledge of patient safety positively, it is necessary to integrate patient safety education into the current medical education curriculum.
ObjectiveTo investigate and analyze the knowledge, skills and attitudes of nursing students to patient safety before and after internship so as to provide evidence for implementation of patient safety curriculum in nursing students. MethodsUndergraduate nursing students before and after internship in nursing school of Wannan Medical College were recruited. The questionnaire method was performed to investigate the knowledge, attitudes and skills of patient safety before and after the internship. The data were input using EpiData 3.0 software and were analyzed by SPSS 13.0. ResultsA total of 451 questionnaires were distributed before the internship and of which 435 nursing students completed the survey (96.45%), 418 questionnaires were distributed after the internship, of which 412 (98.56%) nursing students completed the survey. There were significant higher scores in female nursing students after the internship in the items of 'Knowledge about medical errors' and 'What am I supposed to do when medical errors occur' (P=0.000 and 0.000, respectively), while lower scores of the items of 'Feelings about making errors' and 'Your intentions regarding patient safety' (P=0.002 and 0.006, respectively). Only the score of the item 'What am I supposed to do when medical errors occur' was significantly higher in male nursing students after the internship (P=0.046). ConclusionThe internship is useful for improving experiencing practice, knowledge on patient safety, reduce the negative feelings about making errors.