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目的通过分析四国一区ICU风险管理政策指南、机构管理和运行机制等,为我国ICU风险管理提供决策依据和政策建议。方法计算机检索PubMed,、EMbase,Cochrane Library等数据库,纳入美国、英国、加拿大、澳大利亚和中国台湾地区ICU风险管理相关指南、研究报告等文献,综合分析四国一区风险管理的机构和运行机制,并重点关注英国模式。结果共纳入31篇文献,包括1篇指南、5篇综述、2篇调查报告和23篇研究。英国以标准和指南形式指导ICU风险管理,制定明确的事件分级工具和相应响应机制。美国借鉴澳大利亚经验建立了ICU安全报告系统,二者均将ICU作为整个医疗风险管理的一部分,设立专门的管理板块。结论英国将ICU风险管理纳入国家病人安全管理范围,单独设立报告系统,是目前较完备的系统。澳、美由国家机构设立ICU风险管理研究项目,行业协会和非政府组织主导风险研究,由试点单位使用后逐步推广使用。
Objective To provide decision-making basis and policy recommendations for the ICU risk management in China by analyzing the ICU risk management policy guidelines, institutional management and operation mechanisms in the four countries and one region. Methods Databases such as PubMed, EMbase and Cochrane Library were searched by computer and included relevant guides and research reports on ICU risk management in the United States, Britain, Canada, Australia and Taiwan of China. The risk management mechanism and operation mechanism of the four countries and one district were comprehensively analyzed. Focus on the British model. Results A total of 31 articles were included, including one guideline, five reviews, two surveys and 23 studies. The UK guides ICU risk management in the form of standards and guidelines, with clear incident rating tools and corresponding response mechanisms. Drawing on Australia’s experience, the United States has established an ICU safety reporting system, both of which set the ICU as part of the overall medical risk management and set up a special management section. Conclusions The UK has integrated the ICU risk management into the national patient safety management and set up a reporting system independently. It is now a relatively complete system. Australia, the United States established by the national institutions ICU risk management research projects, industry associations and non-governmental organizations dominate the risk study by the pilot units to gradually promote the use of.