参与 WHO"患者为患者安全"活动,做一个明智的患者

在公众中倡导“患者为患者安全”活动有助于患者和医疗服务提供者创建和提供安全可靠、极具人性化的卫生保健体系和优质服务,有助于促进卫生保健体系真正实现“以患者为中心”。本文简述“患者为患者安全”项目的基本目的、内容和意义,探讨患者如何参与患者安全项目,帮助医疗服务提供者共同杜绝和避免医疗过失。     

WHO患者参与患者安全工作会2010年1月25～27日在瑞士日内瓦召开

“患者为患者安全”（Patients for Patient Safety，PPS）项目是WHO世界患者安全联盟倡导的患者安全的六个行动纲领之一，旨在代表患者心声，建立患者和患者安全倡导者及卫生用户参与的国际网络，倡导患者安全，协助卫生保健从业者减少和避免危害患者健康的一切医疗过失。     

参与WHO世界患者安全联盟工作,迎接新挑战

最近,中国循证医学中心代表参加了WHO世界患者安全联盟2005欧盟峰会,了解了相关领域最新动态,参与讨论和制定"患者参与的患者安全"项目的宗旨、未来目标及远景规划,了解了我国与国际上存在的差距,寻求共同感兴趣的合作机会,为进一步促进和规划我国在相关领域的发展提供借鉴.     

患者参与患者安全的策略及其影响因素的研究概况与展望

患者安全是近年来国内外卫生保健领域关注的热点,保障患者安全、提高卫生保健质量已成为当前卫生保健质量的核心主题.患者参与患者安全（patient for patient safety,PFPS）是WHO患者安全项目（The patient safety programme,WHO Patient Safety）倡导的促进患者安全的主要策略之一.     

患者参与患者安全研究进展与展望

正向患者提供安全有效的卫生保健服务始终是各国卫生保健服务的根本宗旨。为促进患者安全,世界卫生组织(World Health Organization,WHO)及各国相关机构做出了诸多积极的努力,其中由WHO世界患者安全联盟于2004年启动的"患者参与患者安全"(patient for patient safety,PFPS)项目~([1])即为其中的重要举措之一。近年来,PFPS项目取得了诸多卓有成效     

中国参加“全球患者安全倡议活动”启动仪式暨“医院感染与患者安全研讨会”概况

患者安全是全球医疗护理领域中永恒的主题,医院感染是当今世界医学界面临的一大难题。2004年,WHO世界患者安全联盟成立,在全球掀起以关注卫生保健为核心的“全球患者安全倡议活动”,主题是“清洁卫生更安全”。中国是一个拥有13亿人口的大国,人口占了全世界总人口的22%,2006年全国医院承担了14.71亿人次的诊疗任务和5562万住院患者的医疗护理工作,因此加强对医院感染的预防与控制工作,对保障患者安全、提高医疗质量、降低医疗费用具有重要的意义。中国政府非常重视医院感染预防与控制工作,2007年11月27日,卫生部副部长黄洁夫在中国参加“全球患者安全倡议活动”启动仪式上代表卫生部与WHO签署了有关协议,并发表了“卫生部支持预防和控制医院感染、保障患者安全的声明”。在启动仪式之后的“医院感染与患者安全研讨会”上,中外医院感染控制专家共同研讨应对医院感染,保障患者安全的策略。护理工作是医疗工作的重要组成部分,护理人员承担的诊疗护理、消毒、隔离等工作直接关系到医院感染的发生与控制。所以在医院感染的预防与控制、保障患者安全的工作中,护理人员是一支重要的力量。为让各级护理管理者和广大护理人员了解会议精神,用我们的行动去履行并实践卫生部的承诺,本栏目特刊出一组文章,由参加启动仪式和研讨会的WHO及我国卫生行政管理部门相关负责人、国内外医院感染控制专家撰写,部分稿件由本刊编辑部根据现场资料整理。     

WHO全球患者安全挑战：提高手术安全，挽救更多生命

倡导患者安全活动，是21世纪WHO在全球的重要举措之一，是全球极为重视的课题和难题。本文概述了WHO第二次全球病人安全挑战“安全手术，挽救生命”的主要内容、目的及相关最新动态，探讨外科医生如何参与患者安全项目，共同杜绝和避免医疗过失，提高手术安全，挽救更多生命。     

医务人员对患者参与患者安全认知的研究进展

综述了“患者参与患者安全”项目的由来及相关概念；医务人员对患者参与患者安全的认知研究现状及相关影响因素；当前“患者参与患者安全”项目面临的挑战。以期为患者参与患者安全活动的顺利开展提供依据。     

患者参与患者安全的影响因素分析

患者安全是指将卫生保健相关的不必要伤害减少到可接受的最低程度的风险控制过程[1]。作为患者安全的一个重要主体,患者参与在识别医疗风险、降低医疗差错过程中发挥着独特的作用。但在医疗系统中,要鼓励患者参与安全管理,首先就必须了解患者参与安全管理的相关影响因素。因此本文在大量阅     

患者为患者安全伦敦宣言

我们,患者为患者安全,希望实现一个无因医疗过失而受害的世界,我们作为合作伙伴,保护人们不受卫生保健中本可避免的伤害。风险与不确定性始终相伴。因此,我们走到一起进行对话,与医护人员一起参加卫生保健。我们将通力合作,倡导在发展中国家和发达国家消除卫生保健工作中发生的伤害。     

Screening electronic patient records to detect preventable harm: a trigger tool for primary care

Minimising the risk of preventable harm to patients is a National Health Service (NHS) priority in the UK. In the past decade, a patient safety agenda has been established in many secondary care, but is only now migrating to primary care. Information about the epidemiology of error, contributory factors and the scale of preventable harm is limited in comparison to what is known in acute hospitals. We describe how to apply a recently developed trigger tool - a rapid audit method of screening electronic patient records to detect patient harm - as a feasible part of routine primary care practice. We promote the idea that the trigger tool approach will enable care teams and clinicians to refocus their learning and improvement efforts on one of the most serious issues facing the NHS or any modern healthcare system - how to minimise the risks of unintended but avoidable harm to patients.     

Understanding the space of nursing practice in Colombia: A critical reflection on the effects of health system reform

Worldwide, healthcare has been touched by neoliberal policies to the extent that it has some of its characteristics, such as being asymmetrical, competitive, dehumanized, and profit driven. In Colombia, Law 100/93 was created as an ambitious reform aimed at integrating the social security and public sectors of healthcare in order to create universal access, and at the same time to generate market competence with the objective of improving effectiveness and responsiveness. Instead, however, Colombian health reform has served to generate competition which has aggravated inequalities among people. Within this context, we practice nursing. As nurses, our responsibility is to advocate for our patients. We cannot ignore what is happening worldwide in hospitals and community health settings because our responsibility is to promote health, prevent disease, and care for human beings. So, today, when the world pushes for economical profit and competence on one hand, and, on the other, for moral compromises to care, respect, and advocacy for all human beings, being a nurse in the Colombian health system represents a challenge for us. This challenge is especially significant because harm and benefit, justice and injustice, respect and disrespect are separated by a fine line that is easy to transgress.     

Critical care in the developing world - a challenge for us all

The rapid economic growth in parts of the developing world is being accompanied by an expansion of critical care. Hurdles to expansion include lack of critical care training for healthcare workers. This is coupled with a need for a huge number of healthcare workers due to the high populations of countries such as China and India. Intensivists in the developed world can and should help.     

Ethics of everyday decision making

Evidence suggests that checklists can prevent episodes of patient harm and they are increasingly being used in patient care to ensure that procedures are being carried out. However, checklists cannot do so alone and in some situations the checklist might indicate that an intervention has been undertaken when it has not. Healthcare providers, particularly nurses, must consider not only the increase in the use of checklists, but also the way in which they present a context for ethical decision making. This article examines the ethical dimensions of using checklists, played out in the context of a scenario, and suggests that failure to take ethics into account when considering checklists might perpetuate rather than prevent unsafe practices or errors. The article is set in a US context, but the issues are relevant to healthcare settings in any part of the world.     

Technical rationality and the decentring of patients and care delivery: A critique of ‘unavoidable’ in the context of patient harm

In recent decades, debate on the quality and safety of healthcare has been dominated by a measure and manage administrative rationality. More recently, this rationality has been overlaid by ideas from human factors, ergonomics and systems engineering. Little critical attention has been given in the nursing literature to how risk of harm is understood and actioned, or how patients can be subjectified and marginalised through these discourses. The problem of assuring safety for particular patient groups, and the dominance of technical forms of rationality, has seen the word ‘unavoidable’ used in connection with intractable forms of patient harm. Employing pressure injury policy as an exemplar, and critically reviewing notions of risk and unavoidable harm, we problematise the concept of unavoidable patient harm, highlighting how this dominant safety rationality risks perverse and taken‐for‐granted assumptions about patients, care processes and the nature of risk and harm. In this orthodoxy, those who specify or measure risk are positioned as having more insight into the nature of risk, compared to those who simply experience risk. Driven almost exclusively as a technical and administrative pursuit, the patient safety agenda risks decentring the focus from patients and patient care.     

Comparing traditional Medicare and managed care Medicare.

The current healthcare environment presents multiple challenges and opportunities. Patients need in-home health services and managed care companies require prior approvals for these services. There are many demands on the time of home healthcare nurses and supervisors. The following suggestions are offered with the goal of saving time and energy while getting the task accomplished so that patients receive the care they need: Cultivate an ideal relationship with your insurers' case managers. Be flexible. Communicate pertinent information to whomever is responsible for seeking approvals. Provide high-quality patient care that is reflected in the documentation. Inform patients of the prior authorization process as it relates to their home healthcare services (Harris, Lynch, 1996). Fischer and Hurst (1997, p. 16) state that home care providers should adopt a managed care mentality. Linda Pulliam (1989) shared a list of survival skills during a presentation. One of these is "make friends with this changing world" (p. 1). This is excellent advice for all healthcare nurses as we meet the current challenges and anticipate the new ones in the 21st century.     

Mental health nurses' perspectives of people who self‐harm

Self‐harm is a significant health issue, a leading cause of serious injury and is an indicator of psychological distress. Nurses play an important role in providing therapeutic care to people who self‐harm. The aim of this study was to explore mental health nurses’ (MHNs) experience of working with people who self‐harm. Data were collected using semi‐structured interviews and transcribed verbatim from 14 MHNs across Australia. Elo and Kyngäs’ inductive content analysis was used to extract meaning from the data which is reported in accordance with the consolidated criteria for qualitative research guidelines (COREQ). Two categories were identified which captured the MHNs’ experiences of working with people who self‐harm: (i) Nurses’ level of preparedness to work with people who self‐harm; and (ii) The healthcare system. Several sub‐categories were identified. Attitudes, knowledge, skills, and support from others influenced their experience of working with people who self‐harm. Clinical and life experience, undergraduate programme preparation and ongoing education all contributed towards developing therapeutic care with this group of patients. Nurses are vital in the care of people who self‐harm and an accurate understanding of the functions of self‐harm focuses therapeutic interactions to manage psychological distress and reduce further self‐harm and lessen the risk of suicide.     

The perinatal safety nurse: exemplar of transformational leadership

There is increased attention to the issue of patient safety in the care of pregnant women and their infants. The Joint Commission has issued sentinel event alerts regarding infant and maternal morbidity and mortality. Hospitals and healthcare systems are implementing perinatal patient safety programs to minimize the risk of preventable patient harm. This article describes the role of the perinatal patient safety nurse as one aspect of a comprehensive initiative to promote patient safety for women who give birth. Nurses and organizations offering perinatal care are encouraged to incorporate the role of perinatal patient safety nurse in their patient safety efforts.     

Improving patient safety and incident reporting

Patient safety is currently an international priority in health care, as it is widely accepted that the quality of healthcare provision, in terms of reducing errors and other forms of unnecessary patient harm, needs to be improved significantly. This article describes the work and position of the National Patient Safety Agency (NPSA) in NHS-funded care. It outlines the contribution made by two nurses who, as clinical specialty advisers (CSAs) in the organisation, are charged with helping to ensure that nursing issues are considered as an integral part of developing solutions to patient safety issues.