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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Iatrogenesis in neonatal intensive care units: observational and interventional, prospective, multicenter study.
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Iatrogenesis in neonatal intensive care units: observational and interventional, prospective, multicenter study.

机译：新生儿重症监护室的医源性研究：观察性和介入性，前瞻性，多中心研究。

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OBJECTIVES: The goals were to determine the incidence of iatrogenic events in NICUs and to determine whether awareness of iatrogenic events could influence their occurrence. METHODS: We performed a prospective, observational, interventional, multicenter study including all consecutive infants hospitalized in 4 NICUs. In the first 3 months (observation period), the medical teams were unaware of the study; in the next 3 months (intervention period), they were made aware of daily ongoing monitoring of iatrogenic events by a designated Iatrogenesis Advocate. were comparable during the observation and intervention periods (328 and 369 infants, respectively). There was no difference between the 2 periods with respect to the number of infants of <1500 g, hospitalization days, or mean daily occupancy of the NICUs. Although the prevalence rates of iatrogenic events were comparable in the observation and intervention periods (18.0 and 18.2 infants with iatrogenic events per 100 hospitalized infants, respectively), the incidence rate decreased significantly during the intervention period (3.2 and 2.4 iatrogenic events per 100 hospitalization days of new admissions, respectively). Of all iatrogenic events, 7.9% were classified as life-threatening and 45.1% as harmful. There was no death related to an iatrogenic event. Eighty-three percent of iatrogenic events were considered preventable, of which 26.9% resulted from medical errors in ordering or delivery of medical care. Only 1.6% of all iatrogenic events were intercepted before reaching the infants, and only 47.0% of iatrogenic events were corrected. For younger and smaller infants, the rate of iatrogenic events was higher (57% at gestational ages of 24 to 27 weeks, compared with 3% at term) and the iatrogenic events were more severe and harmful. Increased length of stay was associated independently with more iatrogenic events. CONCLUSIONS: Neonatal medical teams and parents should be aware of the burden of iatrogenesis, which occurs at a significant rate.
机译：目的：目标是确定NICU中医源性事件的发生率，并确定对医源性事件的认识是否会影响其发生。方法：我们进行了一项前瞻性，观察性，干预性，多中心研究，包括在4个重症监护病房住院的所有连续婴儿。在最初的3个月（观察期）中，医疗团队并未意识到这项研究。在接下来的3个月（干预期）中，他们被指定的Iatrogenesis倡导者了解每天对医源性事件的持续监控。在观察和干预期间具有可比性（分别为328和369例婴儿）。在两个时期之间，相对于<1500 g的婴儿数量，住院天数或平均重症监护病房的日均占用率没有差异。尽管在观察和干预期间医源性事件的发生率是可比的（每100例住院婴儿中分别有18.0和18.2例婴儿发生医源性事件），但在干预期间发病率显着下降（每100住院天3.2例和2.4例医源性事件）的新招生）。在所有医源性事件中，有7.9％被归类为威胁生命，有45.1％被列为有害。没有与医源性事件有关的死亡。百分之八十三的医源性事件被认为是可预防的，其中26.9％是由于订购或提供医疗服务中的医疗错误造成的。在所有婴儿中，只有1.6％的医源性事件被拦截，只有47.0％的医源性事件得到纠正。对于年龄较小的婴儿，医源性事件的发生率较高（24至27周胎龄为57％，足月为3％），医源性事件更为严重和有害。住院时间增加与更多医源性事件独立相关。结论：新生儿医疗队和父母应该意识到医源性疾病的负担，这种情况的发生率很高。

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