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.
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.
Informing is an initiative behavior of medical staff in their clinical practice. Besides, informing is a key principle of informed consent. The number of cases of infringing upon patient’s informed consent is increasing because of the underestimate or ignorance of the obligation of informing. This paper discusses the concept, significance, content, and procedure of informing as well as the relationship between informed consent and informing.
During the medical rescue of Wenchuan earthquake, West China Hospital immediately shifted to the two-track emergent system mode. More works have been done in time to cure and treat those critically ill patients effectively and to protect the medical safety of patients. The Activated Contingency Plans for major disasters have been started up to evacuate safely those mild patients in the hospital,to prevent out of danger and other accidents. More works have done on the identification of the injured or patients to improve the accuracy and strictly implement the "three investigations and seven right" system to prevent a wrong operation, or a wrong prescription, or a wrong transfusion. We have worked carefully on the referral the wounded, to referr the wounded to those Hospitals in Chengdu or other province and to prevent security incidents.
Nursing staff is one kind of health care professionals who have the most contact with patients and plays an important role in improving patient safety. Patients safety education is a considerable way to raising nurses’ consciousness related to the patient safety. And this paper describes the current status, analyzes the current problems and proposes some suggestions in order to promote the standardization, systematization and scientificization of patient safety education for nursing staff 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.
Objective Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. Methods?We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. Results?A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province/district, hospital, and non-governmental organization. Conclusion?The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an “NGO-led mode” represented by the United States and Canada and a “government-led mode” represented by the United Kingdom, Australia, and Taiwan.