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Patient Participation: Current Knowledge and Applicability to Patient Safety

机译:病人参与:病人安全的最新知识和适用性

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摘要

Patient participation is increasingly recognized as a key component in the redesign of health care processes and is advocated as a means to improve patient safety. The concept has been successfully applied to various areas of patient care, such as decision making and the management of chronic diseases. We review the origins of patient participation, discuss the published evidence on its efficacy, and summarize the factors influencing its implementation. Patient-related factors, such as acceptance of the new patient role, lack of medical knowledge, lack of confidence, comorbidity, and various sociodemographic parameters, all affect willingness to participate in the health care process. Among health care workers, the acceptance and promotion of patient participation are influenced by other issues, including the desire to maintain control, lack of time, personal beliefs, type of illness, and training in patient-caregiver relationships. Social status, specialty, ethnic origin, and the stakes involved also influence patient and health care worker acceptance. The London Declaration, endorsed by the World Health Organization World Alliance for Patient Safety, calls for a greater role for patients to improve the safety of health care worldwide. Patient participation in hand hygiene promotion among staff to prevent health care—associated infection is discussed as an illustrative example. A conceptual model including key factors that influence participation and invite patients to contribute to error prevention is proposed. Further research is essential to establish key determinants for the success of patient participation in reducing medical errors and in improving patient safety.
机译:越来越多的患者参与被认为是重新设计卫生保健流程的关键组成部分,并被提倡为提高患者安全性的一种手段。该概念已成功应用于患者护理的各个领域,例如决策和慢性病管理。我们回顾了患者参与的起源,讨论了其有效性的公开证据,并总结了影响其实施的因素。与患者相关的因素,例如是否接受新患者角色,缺乏医学知识,缺乏信心,合并症以及各种社会人口统计学参数,都会影响参与医疗保健过程的意愿。在卫生保健工作者中,患者参与的接受和促进还受到其他问题的影响,包括保持控制的愿望,时间不足,个人信仰,疾病类型以及患者与护理者关系的培训。社会地位,专业,种族出身以及所涉及的利益也影响患者和医护人员的接受程度。世界卫生组织世界患者安全联盟认可的《伦敦宣言》呼吁患者在提高世界范围内医疗保健安全性方面发挥更大作用。作为示例,讨论了患者参与员工手部卫生促进以预防卫生保健相关感染的情况。提出了一个概念模型,该模型包括影响参与并邀请患者参与预防错误的关键因素。进一步的研究对于确定患者参与成功减少医疗错误和提高患者安全性的关键决定因素至关重要。

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