ECRI发布全新2020年度十大医疗技术安全隐患

2019-10-16 国际妹 健康界

近日,美国非营利性机构——急救医学研究所(Emergency Care Research Institute, ECRI)发布了一份特殊报告——《2020年十大医疗技术安全隐患》(Top 10 Health Technology Hazards for 2020),并在报告中指出,在急救环境之外使用的医疗设备,例如床旁超声检测(point-of-care ultrasound),以及快速发展超过安

近日,美国非营利性机构——急救医学研究所(Emergency Care Research Institute, ECRI)发布了一份特殊报告——《2020年十大医疗技术安全隐患》(Top 10 Health Technology Hazards for 2020),并在报告中指出,在急救环境之外使用的医疗设备,例如床旁超声检测(point-of-care ultrasound),以及快速发展超过安全评估范围的设备(即机器人),属于最危险的医疗技术,但在报告中位列第一的却是外科缝合器。

ECRI表示,该报告中提出的患者安全风险可以通过严谨的管理措施避免或最小化。

以下是ECRI 报告列出的十大医疗技术安全隐患。

No.1 外科缝合器的错误使用

ECRI称,不良事件最常见的原因是缝合器的错误使用而不是设备故障,其后果可能是致命的。这些错误使用包括:选择错误的缝钉尺寸;钉在过厚或者过薄的组织上;钉过了或者钉在其他器械或手术钳上。根据FDA数据, 2011年至2018年,共有412起与外科缝合器和缝钉有关的患者死亡事件。

No.2 床旁超声检测

报告称,床旁超声检测(Point-of-care Ultrasound, POCUS)指临床医生在病床边使用超声检查。该技术的使用缺乏监督,包括何时使用以及如何使用,而这可能使患者和医院都处于危险之中。POCUS 扫描仪因便携,价格相对便宜又易于使用,在医疗领域快速得到广泛使用。但是许多医疗机构的必要培训以及保障措施并没有跟上该技术迅速被使用的步伐。因此,当需要影像专家进行更加全面的检查时,会产生许多问题包括误诊以及对POCUS扫描仪过度依赖。

No.3 无菌处理错误

ECRI称,由于错误发生率未知,对器械或者植入物不正确的无菌处理,可能会导致潜在并广泛存在的患者安全“隐患”。由于缺乏一致性,有效的消毒也有可能会使患者直接接触致病性病菌,但是牙科诊所和医疗办公室包括妇产科以及皮肤病科在内,可能缺乏急救科中常见的规划资源。

No.4 家中血液透析

ECRI指出,更多地使用家中血液透析治疗晚期肾脏疾病,可能会给通过中央静脉导管接受漫长治疗的患者带来风险。因为将导管置于较大的中央静脉(例如颈静脉)中会增加感染、凝血、导管断连而流血和空气栓塞的可能性,而家庭护理人员没有足够的能力去应对这些潜在风险。

No.5 未经验证的机器人手术

ECRI警告,随着外科手术机器人用途的扩大,在某些情况下,机器人会在未完成风险评估前被用于辅助做手术。FDA在今年早些时候宣布,在一些癌症相关的手术之后,机器人的使用与之后的并发症发展之间存在一定联系。癌症还只是机器人经过有限测试还没未被官方允许使用的领域之一。

No.6 过多警告和通知的IT系统

ECRI认为,过多的由医疗设备和医疗IT系统发出的警报和通知,让临床医生不堪重负,这也有可能让他们错过具有重大临床意义的事件。对于承受使用电子病历和其他IT技术压力的医生以及其他医务人员而言,技术超负荷造成的倦怠是一个巨大的挑战。

No.7 家庭健康网络安全

报告称,越来越多地使用远程病人监护也带来了更多挑战,其中包括对家庭网络的依赖,对故障排除和安装更新的访问权限有限以及难以合规。报告显示,这些可能会导致误诊或者延误治疗。

No.8 缺乏植入物数据

ECRI称,目前的电子健康记录中缺乏植入物信息,这可能会对进行MRI扫描的患者造成伤害,因为某些植入物暴露在MRI系统的磁场中会发热,移动或发生故障。

No.9 用药时间错误

根据患者的病情,医生的医嘱以及系统自动生成的EHR工作清单之间的用药剂量时间差异,可能会产生严重的临床后果。尽管医疗机构之间已经开始推广电子处方,但是用药错误的风险仍然值得关注。

No.10 螺母和螺栓松动

ECRI表示,如果未能维护医疗设备中的机械紧固件,时间一长会松动,从而导致灾难性事故的发生。从小的婴儿秤推车到大型血管造影系统,部件掉落都可能带来严重伤害。

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    2020-05-01 howi
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    2019-10-18 diushouji
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    2019-10-17 txqjm

    谢谢了,学习

    0