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• W2049346152 abstract "Una creciente preocupación en la bibliografía médica anglosajona sobre los errores médicos desde 1991 ha cristalizado en el informe del Institute of Medicine (IOM) en 1998, que ha llevado al gobierno norteamericano a elaborar unos planes nacionales para tratar el tema y la creación de un comité sobre Quality of Health Care in America con la participación de destacadas figuras de la política, administración sanitaria y sociedades cientificas médicas. Varias consideraciones generales se derivan de la revisión de Medline: 1. Se presentan desviaciones en entre el 3,7 y el 45,8% de los ingresos hospitalarios. Tienen una mortalidad variable entre el 4,9 y el 5,6%. De ellas, entre un 51 y un 54% son prevenibles. Sólo un 27% pueden catalogarse como negligencias. 2. Error médico, adverse events, desviaciones, incidentes o hechos centinela son distintas maneras de definir lo que se pretende estudiar. 3. Las desviaciones pocas veces se deben a un factor humano personal aislado, sino que se asocian a un conjunto de causas coincidentes y subyacentes cuyo análisis es fundamental para comprender y poder prevenir la repetición del hecho. 4. El error humano no indica, en la mayor parte de los casos, una falta de formación sino un fallo en la manera de actuar en un momento dado. La psicología cognitiva intenta explicar y aportar luz en el mecanismo de comportarse la memoria, el razonamiento y la actuación de las personas. 5. No es por la persecución legal como se reducen estos hechos, sino por una prevención. La experiencia de las normas aplicadas por la industria, y más concretamente por la aviación civil, puede ser adaptada al sistema sanitario. 6. La colaboración del personal sanitario es fundamental para conocer los hechos y sus circunstancias. Lo que requiere confidencialidad y ausencia de represalias. 7. Ante la realidad de las desviaciones y su importancia se requiere un cambio cultural para transformar una actitud tradicionalmente defensiva en una conducta colaboradora buscando mejorar la calidad de la asistencia. The increasing concern about medical errors reported in the English-language medical literature from 1991 onwards led to the Institute of Medicine Report in 1998. This stimulated the North American government to create national plans to deal with the problem and to form the Quality of Health Care in America Committee composed by outstanding politicians, health care administrators and scientific and medical societies. Several general considerations can be drawn from a MEDLINE review: 1. Between 3.7% and 45.8% of inpatients suffer adverse events. Mortality ranges between 4.9% and 5.6%. Between 51% and 54% of these deaths are preventable. Only 27% can be classified as negligence. 2. Medical error, adverse events, adverse incidents, malpractice or negligence are different ways of defining the subject under study. 3. Adverse events are rarely due to human error alone but are usually associated with a series of coinciding and underlying causes that must be analyzed to understand and prevent repetition. 4. In most cases, human error does not indicate lack of training but rather a failure to act appropriately in a particular moment. Cognitive psychology attempts to explain and throw light on the mechanisms governing human memory, reasoning and performance. 5. Reduction of these events will not be achieved by litigation but rather by prevention. The measures put into practice by industry, and more specifically by civil aviation, could be adapted to the health system. 6. Collaboration among health care personnel is fundamental to understanding the facts and the circumstances in which they occur. This requires confidentiality and the absence of reprisals. 7. Because of the importance of adverse events, a change in medical culture is required to transform a traditionally defensive attitude into one of collaboration to improve quality of health care." @default.
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• W2049346152 date "2001-01-01" @default.
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• W2049346152 title "Errores médicos o desviaciones en la práctica asistencial diaria" @default.
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