Objective Airway-related patient safety incident(PSI)has always been the top concern of anesthesiologists because this type of incidents could severely threaten patient safety if not treated immediately and properly.T...Objective Airway-related patient safety incident(PSI)has always been the top concern of anesthesiologists because this type of incidents could severely threaten patient safety if not treated immediately and properly.This study intends to reveal the composition,prognosis,and to identify risk factors for airway related incidents reported by anesthesiologists.Methods All airway related PSIs reported by anesthesiologists in a Chinese academic hospital between September 2009 and May 2022 were collected from the PSI reporting system.Patients with airway incidents reported were matched 1:1 with controls based on sex and type of surgery.Univariable and multivariable analysis were performed to find risk factors associated with airway incident occurrence,and to evaluate influence of airway PSIs on patient prognosis.Results Among 1,038 PSIs voluntarily reported by anesthesiologists during the study period,281 cases(27.1%)were airway-related incidents,with an overall reporting incidence of 4.74 per 10,000 among 592,884 anesthesia care episodes.Only ASA physical status was found to be significant independent predictor of these airway PSIs(P=0.020).Patients with airway PSIs reported had longer extubation time(0.72±1.56 d vs.0.16±0.77 d,95%CI:0.29 to 0.82,P<0.001),longer ICU length of stay(LOS)(1.63±5.71 d vs.0.19±0.84 d,95%CI:0.57 to 2.32,P=0.001),longer post operative LOS(10.56±13.09 d vs.7.59±10.76 d,95%CI:0.41 to 5.53,P=0.023),and longer total in-hospital LOS(14.99±15.18 d vs.11.62±11.88 d,95%CI:0.46 to 6.27,P=0.024).Conclusions This single-center retrospective case-control study describes the composition of airway-related PSIs reported by anesthesiologists within thirteen years.Airway incidents might influence patient prognosis by elongating extubation time and LOS.Airway PSI data were worth analyzing to improve patient safety.展开更多
Purpose： The current development of patient safety reporting systems is criticized for loss of information and low data quality due to the lack of a uniformed domain knowledge base and text processing functionality. ...Purpose： The current development of patient safety reporting systems is criticized for loss of information and low data quality due to the lack of a uniformed domain knowledge base and text processing functionality. To improve patient safety reporting, the present paper suggests an ontological representation of patient safety knowledge. Design/methodology/approach： We propose a framework for constructing an ontological knowledge base of patient safety. The present paper describes our design, implementation,and evaluation of the ontology at its initial stage. Findings： We describe the design and initial outcomes of the ontology implementation. The evaluation results demonstrate the clinical validity of the ontology by a self-developed survey measurement. Research limitations： The proposed ontology was developed and evaluated using a small number of information sources. Presently, US data are used, but they are not essential for the ultimate structure of the ontology.Practical implications： The goal of improving patient safety can be aided through investigating patient safety reports and providing actionable knowledge to clinical practitioners.As such, constructing a domain specific ontology for patient safety reports serves as a cornerstone in information collection and text mining methods.Originality/value： The use of ontologies provides abstracted representation of semantic information and enables a wealth of applications in a reporting system. Therefore, constructing such a knowledge base is recognized as a high priority in health care.展开更多
基金This research was supported by the Education Reform Project Foundation for the Central Universities of Peking Union Medical College(2020zlgc0105).
文摘Objective Airway-related patient safety incident(PSI)has always been the top concern of anesthesiologists because this type of incidents could severely threaten patient safety if not treated immediately and properly.This study intends to reveal the composition,prognosis,and to identify risk factors for airway related incidents reported by anesthesiologists.Methods All airway related PSIs reported by anesthesiologists in a Chinese academic hospital between September 2009 and May 2022 were collected from the PSI reporting system.Patients with airway incidents reported were matched 1:1 with controls based on sex and type of surgery.Univariable and multivariable analysis were performed to find risk factors associated with airway incident occurrence,and to evaluate influence of airway PSIs on patient prognosis.Results Among 1,038 PSIs voluntarily reported by anesthesiologists during the study period,281 cases(27.1%)were airway-related incidents,with an overall reporting incidence of 4.74 per 10,000 among 592,884 anesthesia care episodes.Only ASA physical status was found to be significant independent predictor of these airway PSIs(P=0.020).Patients with airway PSIs reported had longer extubation time(0.72±1.56 d vs.0.16±0.77 d,95%CI:0.29 to 0.82,P<0.001),longer ICU length of stay(LOS)(1.63±5.71 d vs.0.19±0.84 d,95%CI:0.57 to 2.32,P=0.001),longer post operative LOS(10.56±13.09 d vs.7.59±10.76 d,95%CI:0.41 to 5.53,P=0.023),and longer total in-hospital LOS(14.99±15.18 d vs.11.62±11.88 d,95%CI:0.46 to 6.27,P=0.024).Conclusions This single-center retrospective case-control study describes the composition of airway-related PSIs reported by anesthesiologists within thirteen years.Airway incidents might influence patient prognosis by elongating extubation time and LOS.Airway PSI data were worth analyzing to improve patient safety.
基金supported by a grant from AHRQ, 1R01HS022895a patient safety grant from the University of Texas system, #156374
文摘Purpose： The current development of patient safety reporting systems is criticized for loss of information and low data quality due to the lack of a uniformed domain knowledge base and text processing functionality. To improve patient safety reporting, the present paper suggests an ontological representation of patient safety knowledge. Design/methodology/approach： We propose a framework for constructing an ontological knowledge base of patient safety. The present paper describes our design, implementation,and evaluation of the ontology at its initial stage. Findings： We describe the design and initial outcomes of the ontology implementation. The evaluation results demonstrate the clinical validity of the ontology by a self-developed survey measurement. Research limitations： The proposed ontology was developed and evaluated using a small number of information sources. Presently, US data are used, but they are not essential for the ultimate structure of the ontology.Practical implications： The goal of improving patient safety can be aided through investigating patient safety reports and providing actionable knowledge to clinical practitioners.As such, constructing a domain specific ontology for patient safety reports serves as a cornerstone in information collection and text mining methods.Originality/value： The use of ontologies provides abstracted representation of semantic information and enables a wealth of applications in a reporting system. Therefore, constructing such a knowledge base is recognized as a high priority in health care.
