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.
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.
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.
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.
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.
ObjectiveTo explore the effect of patient safety education course on the undergraduate nursing students in terms of knowledge, attitude and skills about patient safety. MethodsWe enrolled five-year undergraduates admitted to Wannan Medical College in 2009. Eighty two nursing students who took part in the elective course of patient safety education course at the first semester of the seniors were selected as the observation group; while the other 359 nursing students who did not took part in the course were selected as the control group. The questionnaire method was performed to investigate the knowledge, attitude and skills about patient safety before and after the course. ResultsThere were significant higher scores in the observation group than in the control group in the following domains:"Knowledge of medical errors" and "What should I do after medical errors occur?". ConclusionSetting up "patient safety education" course could significantly improve the knowledge, attitude and skills about patient safety for undergraduate nursing students.
Day surgery is a new mode of diagnosis and treatment, and is greatly honoured and rewarded abroad. In China, day surgery begins rather later, but it has been gradually spread and applied in some large hospitals for its shorter hospital stay and less hospitalization cost. Day surgery management is a process including admission, operation, and discharge that should be finished within 24 hours, so the guarantee of medical quality and patient safety is principal factor of sustainable development influencing day surgery. This paper introduces the specifications for the quality and safety management of day surgery in West China Hospital of Sichuan University, to regulate and promote the application of day surgery, and further improve the medical quality and safety of day surgery.
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.