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医生为什么会在手术中出现严重失误

2015-06-11 Ivy 煎蛋网

你可能听说过四年前一名女子接受子宫切除时,医生把一块海绵留在其体内,又或者听说过一名男子在接受肾移植时,医生错把右边的肾接到了左边。最近一项调查发现,在美国,手术中严重失误(包括移植错误以及错误的手术操作)的发生率为1/12000。为了了解其中的原因,一组来自纽约梅奥诊所的研究者决定利用诊所内失败手术的数据来进行分析。研究人员利用了一种称为人为因素分析与归类系统的航空事故分析工具,来找出有问题的手



你可能听说过四年前一名女子接受子宫切除时,医生把一块海绵留在其体内,又或者听说过一名男子在接受肾移植时,医生错把右边的肾接到了左边。

最近一项调查发现,在美国,手术中严重失误(包括移植错误以及错误的手术操作)的发生率为1/12000。为了了解其中的原因,一组来自纽约梅奥诊所的研究者决定利用诊所内失败手术的数据来进行分析。

研究人员利用了一种称为人为因素分析与归类系统的航空事故分析工具,来找出有问题的手术中哪些认为因素最为常见。通过从手术事故后的报告中找出细节。通过从手术事故后的报告中获得细节,研究人员分析了69例手术失败的手术。

分析工具中包括161中人为错误,并被分成具体的类别。研究人员发现,严重的手术事故通常包含许多人为因素,这些事故中平均有9个不同的过失。最常见的问题出现在医生和护士的心理状态,包括过度自信,以及过分关注某个细节而丧失了对整体的把握。另一类主要的问题是决策失误,比如没能了解手术的风险,或者混淆名称相似的手术操作、测试和药物。相比之下,疏忽的因素以及组织因素,比如经费不足,则不太可能称为手术失误的原因。

研究结果说明手术团队精神负荷太大,才导致了心理有关错误的发生。其他研究发现,较复杂的手术和技术以及健康状况较复杂的病人,都会消耗医生和护士的脑力,这可能会让他们在不经意间出现错误。

研究人员并没有提出具体的改善方法,不过他们指出,可以通过减少医护人员做手术的频率,或者让他们更他们更自主(不用什么事都和同一个很忙的上司商量),来减少他们的精神压力。所以,要减少手术中的人为错误,首先要减轻参与手术的人的压力。

原始出处:

Why Surgeons Make Catastrophic Mistakes.Paxific Standard.June 5,2015

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    2015-06-29 owlhealth

    0

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    2015-06-25 huaxipanxing

    看看

    0

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    2015-06-13 chenguoyan

    谢谢楼主的分享

    0

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    2015-06-13 chenguoyan

    就是差距有点大

    0

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    2015-06-13 chenguoyan

    期待中国的进驻世界先进行列

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=29945, encodeId=a92c29945eb, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Jun 29 19:02:00 CST 2015, time=2015-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=29423, encodeId=1ac529423ca, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=200, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Thu Jun 25 23:50:00 CST 2015, time=2015-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27543, encodeId=e2212e5434b, content=谢谢楼主的分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:20:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27541, encodeId=0beb2e541b6, content=就是差距有点大, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:19:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27542, encodeId=40b42e542da, content=期待中国的进驻世界先进行列, beContent=null, objectType=article, channel=null, level=null, likeNumber=177, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:19:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27539, encodeId=92de2e53921, content=这是世界先进吧?, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:18:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27540, encodeId=86932e5409d, content=这就是差距吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:18:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27245, encodeId=07ab2e24515, content=国内的话关注的就是赔偿了多少, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dcb01604905, createdName=hcz5759, createdTime=Fri Jun 12 07:54:00 CST 2015, time=2015-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27226, encodeId=a6472e22680, content=努力避免, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e5c31627260, createdName=Darcy2500, createdTime=Thu Jun 11 23:45:00 CST 2015, time=2015-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27215, encodeId=bc5e2e21568, content=严峻, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Thu Jun 11 22:48:00 CST 2015, time=2015-06-11, status=1, ipAttribution=)]
    2015-06-13 chenguoyan

    这是世界先进吧?

    0

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    2015-06-13 chenguoyan

    这就是差距吧

    0

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    2015-06-12 hcz5759

    国内的话关注的就是赔偿了多少

    0

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    2015-06-11 Darcy2500

    努力避免

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=29945, encodeId=a92c29945eb, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Mon Jun 29 19:02:00 CST 2015, time=2015-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=29423, encodeId=1ac529423ca, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=200, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Thu Jun 25 23:50:00 CST 2015, time=2015-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27543, encodeId=e2212e5434b, content=谢谢楼主的分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:20:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27541, encodeId=0beb2e541b6, content=就是差距有点大, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:19:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27542, encodeId=40b42e542da, content=期待中国的进驻世界先进行列, beContent=null, objectType=article, channel=null, level=null, likeNumber=177, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:19:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27539, encodeId=92de2e53921, content=这是世界先进吧?, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:18:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27540, encodeId=86932e5409d, content=这就是差距吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db141627504, createdName=chenguoyan, createdTime=Sat Jun 13 10:18:00 CST 2015, time=2015-06-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27245, encodeId=07ab2e24515, content=国内的话关注的就是赔偿了多少, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dcb01604905, createdName=hcz5759, createdTime=Fri Jun 12 07:54:00 CST 2015, time=2015-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27226, encodeId=a6472e22680, content=努力避免, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e5c31627260, createdName=Darcy2500, createdTime=Thu Jun 11 23:45:00 CST 2015, time=2015-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27215, encodeId=bc5e2e21568, content=严峻, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Thu Jun 11 22:48:00 CST 2015, time=2015-06-11, status=1, ipAttribution=)]
    2015-06-11 zhouanxiu

    严峻

    0

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