Current Situation And Influencing Factors Of Pediatric Medical Risk

[Purpose]Pediatric medical risk events seriously endanger the safety of children and the reputation of the hospital.Pediatrics is a major.Children’s physiological structure and anatomical structure are greatly different from those of adults.Children are not the reduced version of adults.Children’s medical safety has always been a high social concern.Therefore,it is necessary to study the pediatric medical risk,understand the distribution,in order to analyze the causes and influencing factors of pediatric medical risk,and then put forward the prevention and control strategy of pediatric risk Suggestions to provide reference for pediatric medical risk prevention and control.[Methods] 1.Literature analysis method: by searching Wanfang medical database with keywords of "Pediatrics" and "risk" and "medical risk",more than 50 literatures related to pediatric medical risk were selected manually for research review.The policy documents are sorted out and studied,and the requirements related to quality management and risk management issued by the health administration department are sorted out and studied to obtain the current situation of pediatric medical risk.2.By using mathematical statistics and regression analysis,the pediatric risk events reported by Wuhan children’s Hospital in 2019 were summarized and sorted out,and the top three events with the highest incidence rate were selected for retrospective analysis,including medical events,nursing events,safety management and accidental injury events,and their occurrence regularity,cause analysis,resulting consequences and relevant improvement measures were analyzed The hospital information system retrieved the age,gender,length of stay longer than 30 days,critical value,disease outcome,medical arrears and other related data for univariate analysis。3.Typical case analysis method,through the typical case analysis,improve the pediatric medical risk management strategy.[results](1)285 cases of pediatric medical risk events were mainly divided into eight categories.From the perspective of occurrence probability,the top three medical risk events were: 123 cases of medical events accounting for 43%,72 cases of nursing eventsaccounting for 25%,52 cases of safety management and accidental injury events accounting for 18%,accounting for 86% of the total events.The incidence of hospital related events was the lowest,accounting for only 2% Risk cases are mainly composed of medical events,nursing events,safety management and accidental injury events.(2)Pediatric medical risk mainly occurs in clinical departments,the proportion of medical and technical departments is very low,the top 20 departments are clinical departments;the probability of medical risk occurrence between 8:00 and 12:00 is high;the probability of pediatric medical risk is high for medical staff with junior Title less than 5 years;the vast majority of pediatric medical risks do not cause damage.(3)The causes of pediatric medical risk are mainly composed of medical reasons,patient reasons and social factors,among which the doctor-patient communication is not smooth.It accounted for 68.42% of the medical reasons.Service attitude.Accounting for 12.28% of the medical reasons.Lack of legal consciousness.It accounted for 10.53% of the medical reasons.Lack of technical level and experience.26%.Lack of responsibility.51%.The expectation of treatment effect is too high.56%.There is little understanding of the disease and there are cognitive differences.It accounted for 38.60% of the patients.Lack of trust in medical staff.84%.The medical expenses are high and the economic burden is heavy.Accounting for 82.5% of the social reasons.The public opinion exaggerates excessively.It accounted for 17.5% of the social reasons.(4)The influencing factors of pediatric medical risk include medical factors,patient factors,disease factors and social factors.Among them,medical factors mainly include nine factors: doctor-patient communication,workload,service attitude,hospital management ability,technical level,system implementation degree,sense of responsibility,medical ethics and medical facilities and layout.Patient factors: mainly including three factors: patient’s compliance,children’s constitution and patient’s expectation of diagnosis and treatment.Disease factors: mainly including disease complexity and disease spectrum.Social factors: mainly including medical expenses burden,the total amount and distribution of pediatric medical resources and public opinion.(5)For the medical risk compensation cases,the single factor analysis of medical disputesshows that the patient’s age,critical value,length of stay more than 30 days,cure situation and whether arrears and other factors lead to different probability of pediatric medical risk.[Conclusion] Pediatric medical risk mainly occurs in clinical departments.Pediatric hematology oncology department,cardiothoracic surgery department,orthopedics department,pediatric cardiovascular department and neonatal surgery department are the most common departments of pediatric medical risk events.The probability of pediatric medical risk in working days is high,and the probability of medical risk between 8:00 and12:00 is high.The medical risk in pediatrics is related to the working years of medical staff.The medical staff with primary professional title less than 5 years are prone to medical nursing errors,resulting in pediatric medical risk.The main manifestation of pediatric medical risk is medical error,which is caused by the non-standard behavior of medical staff,poor service attitude and poor communication.The differences in patients’ understanding,the limitation of current medical development level,and the imperfect medical compensation mechanism are also the causes of pediatric medical risks.Doctor patient communication is the most important influencing factor of pediatric medical risk.Medical staff workload and patient compliance have a significant impact on pediatric medical risk.Through taking measures to correct in time,most of the pediatric medical risks did not cause damage.