166例骨科医疗事故案例分析研究

摘要

Objective To summarize the characters and causes of orthopedics medical malpractice to propose prevention counter-measures. Method Descriptive retrospective analysis was performed among 166 cases of orthopedic medical malpractices in a city from 1999 to 2010, and combined with the classification system of medical safety events of JCAHO and Root Cause Analysis (RCA) to study the 20 cases of spinal surgery medical accident cases. Result The second class hospitals had high incidence of orthopedic medical malpractice. Most orthopedic medical malpractice was non -fatal injury, and in general, medical side had the main responsibility with deputy director and attending physician is the main responsible person. The causes could be attributed to improper operation of medical staff, improper doctor - patient communication and supervision. Conclusion It is important to improve the medical personnel technology skills, strengthen the doctor - patient communication, strengthen hospital risk supervision and management, and exchange the technical experiences among different levels hospitals, build up the sound medical accident appraisal system and explore the effective medical accident risk sharing mechanism.%目的 明确骨科医疗事故的特点及发生原因,提出防范对策.方法 对某市1999～2010年发生的166例骨科医疗事故进行回顾分析,结合美国医疗机构评审委员会的医疗安全事件分级分类系统和根本原因分析法,对20例脊柱外科手术医疗事故案例进行典型分析.结果 二级医院是骨科医疗事故的高发单位.骨科医疗事故多为非致命性损伤,一般医方负主要责任,而主要责任人多为副主任医师和主治医师.事故发生原因可归结为医务人员操作不当、医患沟通不到位及监管不利等.结论 应切实提高医务人员业务水平、加强医患沟通、严格风险监管、加强不同级别医院技术交流、健全医疗事故鉴定体系、建立使用的的医疗事故风险分担机制.