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首页> 外文期刊>International journal of health care quality assurance >Reducing wrong intraocular lens implants in cataract surgery 3 years of experience with the SEIP framework in Singapore
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Reducing wrong intraocular lens implants in cataract surgery 3 years of experience with the SEIP framework in Singapore

机译：在白内障手术中减少错误的人工晶状体植入物3年的新加坡SEIP框架经验

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Purpose - Wrong lens implants have been associated with the highest frequency of medical errors in cataract surgery. The purpose of this paper is to explore the use of the Systems Engineering Initiative for Patient Safety (SEIPS) framework to sustainably reduce wrong intraocular lens (IOL) implants in cataract surgery. Design/methodology/approach - In this mixed-methods study, the SEIPS framework was used to analyse a series of (near) misses of IOL implants in a national tertiary specialty hospital in Singapore. A series of interventions was developed and applied in the case hospital. Risk assessment audits were done before the interventions (2012; n = 6,111 surgeries), during its implementation (n = 7,475) and in the two years post-interventions (2013-2015; n = 39,390) to compare the wrong IOL-rates. Findings - Although the absolute number of incidents was low, the incident rate decreased from 4.91 before to 2.54 per 10,000 cases after. Near miss IOL error decreased from 5.89 before to 3.55 per 1,000 cases after. The number of days between two IOL incidents increased from 35 to an initial peak of 385 before stabilizing on 56. The large variety of available IOL types and vendors was found as the main root cause of wrong implants that required reoperation. Practical implications - The SEIPS framework seems to be helpful to assess components involved and develop sustainable quality and safety interventions that intervene at different levels of the system. Originality/value - The SEIPS model is supportive to address differences between person and system root causes comprehensively and thereby foster quality and patient safety culture.
机译：目的-错误的晶状体植入物与白内障手术中出现医疗错误的频率最高相关。本文的目的是探索使用系统工程患者安全倡议（SEIPS）框架来持续减少白内障手术中错误的人工晶状体（IOL）植入物。设计/方法/方法-在这项混合方法研究中，SEIPS框架用于分析新加坡国立三级专科医院的一系列（近）IOL植入物遗漏。开发了一系列干预措施，并将其应用于案例医院。在干预之前（2012年； n = 6,111手术），实施期间（n = 7,475）和干预后的两年内（2013-2015； n = 39,390）进行了风险评估审计，以比较错误的IOL率。调查结果-尽管绝对的发病率很低，但发病率从之前的4.91下降到每10,000例之后的2.54。 IOL差错几率从之前的5.89降至每1,000例之后的3.55。两次IOL事件之间的天数从35天增加到最初的385天，然后稳定在56天。发现各种可用的IOL类型和供应商是需要重新手术的错误植入物的主要原因。实际意义-SEIPS框架似乎有助于评估所涉及的组件并开发可干预系统不同级别的可持续质量和安全干预措施。原创性/价值-SEIPS模型有助于全面解决人与系统根本原因之间的差异，从而促进质量和患者安全文化。

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