Epidemiology of Preventable Safety Events in Prehospital EMS for Children

儿童院前急救中可预防安全事件的流行病学

基本信息

批准号：
8121589
负责人：
JEANNE-MARIE GUISE
金额：
$ 62.39万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-10 至 2015-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8121589
关键词：
Accident and Emergency department Adverse event American Area Caring Child Child Care Child health care Childhood Clinical Medicine Clinical Research Complex Data Data Set Databases Decision Making Development Electronics Elements Emergency Care Emergency Situation Emergency medical service Environment Epidemiology Evaluation Event Focus Groups Foundations Health Health Personnel Hospitals Human Human Resources In Situ Incidence Individual Institute of Medicine (U.S.)International Intervention Investigation Knowledge Lead Light Measures Medical Medical Errors Medical Records Methods NIH Program Announcements Natural Disasters Nature Online Systems Outcome Patient Simulation Persons Play Prehospital Emergency Care Process Provider Publishing Quality Indicator Quality of Care Recording of previous events Records Relative (related person)Reporting Research Research Methodology Research Personnel Resuscitation Role Safety Sampling Science Screening procedure Seizures Series Services Staging Structure System Technology Time Training Trauma Uncertainty Work base data collection evaluation epidemiologic data evidence base hazard health care delivery high risk improved medical malpractice metropolitan new technology patient safety prevent public health relevance response simulation social tool

项目摘要

DESCRIPTION (provided by applicant): Safety is the prerequisite element to quality care for emergency services relating to children. Safety events occurring during the emergency medical care outside the hospital are poorly understood and high quality epidemiologic data are lacking. Background: While quality and safety issues have been analyzed in the hospital setting, safety events have not been evaluated in emergency prehospital services. New technologies provide unprecedented opportunities to conduct epidemiologic and simulation studies. Aims: These studies aim to 1) identify reliable and valid measures for safety events in the prehospital care of children, 2) understand the incidence and contributors to safety events in the prehospital care for children, 3) understand individual, team, and systems issues that lead to safety events during in situ simulation of children's emergencies, and 4) establish a national system for the anonymous reporting of safety events. Methods: We will begin by conducting focus groups with Emergency Medical Services personnel and Emergency Department providers to characterize the range of and contributors to safety events in the EMS care of children. In turn, an expert panel will review a random sample of cases thought to be at high risk for a safety event (e.g., resuscitation, seizures, lights and siren transport) to develop screening and evaluation tools. These tools will be used to screen 1 year of pediatric EMS transports in a metropolitan area to identify safety events. All screen-positive records will be reviewed by an expert panel using a structured tool to confirm the safety event and assess contributing factors and preventability. In a complimentary approach, patient simulations will be used to evaluate the process by which safety events occur. Finally, we will develop a web-based reporting system to capture a broad range of safety events across all EMS systems: some of these events may be rare or undetectable in electronic records. Significance: This series of studies will exploit new technologies -- electronic records, simulation, and web-based reporting -- to develop a comprehensive understanding of safety events relating to the prehospital care of children. Identification of the factors contributing to safety events will inform improvements in training and implementation of safeguards to assure pediatric safety and quality in emergency care. PUBLIC HEALTH RELEVANCE: Safety events occurring in the emergency care of children during transports to the hospital have not been evaluated. This study will use expert panel reviews, analysis of electronic EMS data, and patient simulation to measure the numbers and types of safety events occurring in the prehospital care of children. Identification of the factors contributing to safety events will inform improvements in training and implementation of safeguards to assure pediatric safety and quality in emergency care.

描述（由申请人提供）：安全是儿童相关紧急服务优质护理的先决条件。对院外紧急医疗期间发生的安全事件知之甚少，也缺乏高质量的流行病学数据。背景：虽然已经在医院环境中分析了质量和安全问题，但尚未对紧急院前服务中的安全事件进行评估。新技术为进行流行病学和模拟研究提供了前所未有的机会。目的：这些研究旨在 1) 确定儿童院前护理中安全事件的可靠且有效的措施，2) 了解儿童院前护理中安全事件的发生率和影响因素，3) 了解个人、团队和系统问题儿童突发事件现场模拟中导致安全事件的情况；4）建立国家安全事件匿名报告制度。方法：我们将首先与紧急医疗服务人员和急诊科提供者进行焦点小组讨论，以描述儿童 EMS 护理中安全事件的范围和影响因素。反过来，专家小组将审查被认为存在安全事件（例如复苏、癫痫发作、灯光和警报器传输）高风险的病例的随机样本，以开发筛查和评估工具。这些工具将用于筛查大都市地区为期一年的儿科 EMS 运输，以识别安全事件。所有筛查阳性记录将由专家小组使用结构化工具进行审查，以确认安全事件并评估影响因素和可预防性。在一种补充方法中，将使用患者模拟来评估安全事件发生的过程。最后，我们将开发一个基于网络的报告系统，以捕获所有 EMS 系统中的广泛安全事件：其中一些事件可能很少见或在电子记录中无法检测到。意义：这一系列研究将利用新技术——电子记录、模拟和基于网络的报告——来全面了解与儿童院前护理相关的安全事件。确定导致安全事件的因素将为改进培训和实施保障措施提供信息，以确保儿科急诊护理的安全和质量。公共卫生相关性：尚未评估儿童在送往医院期间紧急护理中发生的安全事件。本研究将利用专家小组评审、电子 EMS 数据分析和患者模拟来衡量儿童院前护理中发生的安全事件的数量和类型。确定导致安全事件的因素将为改进培训和实施保障措施提供信息，以确保儿科急诊护理的安全和质量。