CAJ | 학술논문

目的探讨新型儿童急诊安全医疗运行模式以减少急诊医疗纠纷.方法详细分析本院儿童急诊医疗纠纷和死亡病例的医疗缺陷,据此制定儿童急诊安全医疗运行模式的具体程序.并于2005年10月起,我科全面加以执行该模式.对2005年1月至2007年3月期间病例进行回顾性分析.结果最易引起医疗纠纷的疾病包括儿童暴发性心肌炎、暴发性流行性脑脊髓膜炎、脓毒症.2005年10月至2007年3月期间,执行早期筛选的临床措施后,早期发现了暴发性心肌炎7例.流行性脑脊髓膜炎7例,化脓性脑膜炎6例,发现并汇报潜在医疗纠纷12例,由此阻止潜在严重医疗纠纷3例.在执行安全医疗模式前9个月共21万急诊患儿中,发生严重医疗纠纷和医疗赔偿分别为8例和3例;执行安全医疗模式后17个月共33万急诊患儿中,发生严重医疗纠纷仅1例,无医疗赔偿.结论早期筛选高危患儿的临床措施能提高儿科医师对危重疾病的识别能力.执行儿童急诊安全医疗模式能显著减少严重医疗纠纷.
목적 탐토신형인동급진안전의료운행모식이감소급진의료규분.방법 상세분석본원인동급진의료규분화사망병례적의료결함,거차제정인동급진안전의료운행모식적구체정서.병우2005년10월기,아과전면가이집행해모식.대2005년1월지2007년3월기간병례진행회고성분석.결과 최역인기의료규분적질병포괄인동폭발성심기염、폭발성류행성뇌척수막염、농독증.2005년10월지2007년3월기간,집행조기사선적림상조시후,조기발현료폭발성심기염7례.류행성뇌척수막염7례,화농성뇌막염6례,발현병회보잠재의료규분12례,유차조지잠재엄중의료규분3례.재집행안전의료모식전9개월공21만급진환인중,발생엄중의료규분화의료배상분별위8례화3례;집행안전의료모식후17개월공33만급진환인중,발생엄중의료규분부1례,무의료배상.결론 조기사선고위환인적림상조시능제고인과의사대위중질병적식별능력.집행인동급진안전의료모식능현저감소엄중의료규분.
Objective To explore how to establish the emergency model of medical safety in children to reduce medical disputes.Methotis We retrospectively analyzed the medical records for hospital deaths and medical disputes.And then we formulated the specific procedures of pediatric emergency safety,which included a clinical pathway of early screening model for high-risk patients,establishment of network for reporting potential medical disputes,creating platform to share climcal experience.The pediatric ca.ses from October 2005 to March 2007 were analyzed and a retrospective analysis was conducted to compare the difference before and after medical safety model establishment.Results Fulminant myocarditis and severe infeetions often enused medical disputes.From October 2005 tO March 2007,seven cases of fdminant myocarditis.seven cases of epidemic cerebrcapinal meningitis.and six cases of purulent meningitis were detected in the earlystage.And twelve cases of potential medical disputes were reported in time and three potential severe medical dispute cases were prevented.During the period of nine.months before the implementation of medical safety model,210 000 patients were recruited and 8 cases of medical disputes and 3 ca3es for medical compensation occurred.After the implementation of medical safety model,remarkable improvement had been achieved:during a seventeen month period,1 medical dispute and no medical compensation occurred in a total of 330 000 patients.Conclusion Application of clinical pathway of early screening high-risk patients can improve the early identification of high-risk illness.The implementation of medical safety model can significantly reduce medical disputes.