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丁香园一篇类似话题很有趣，作为参与感控者，很想知道：病人发生医院感染，医生和护士会告诉他（她）吗？这样一来，对医院感染管理是否有利呢？
转贴：儿科医生如果遇到下列两种情形,你会怎么选择?
谢谢作者！
October 6, 2008, 5:28 pm
Doctors More Likely to Tell Patients About Obvious Errors
医生更倾向于告知患者明显的错误。
Consider two medical scenarios.
考虑以下两个医疗事件
In one, a child receives an overdose of insulin and is admitted to the intensive care unit. In the other, a doctor overlooks a lab test, which leads to a child being hospitalized for a serious infection. The insulin overdose would be more apparent to the child’s family, while the overlooked lab test might not be so obvious.
在第一个，一个患儿接受了过量的胰岛素。此后被送入重症监护病房。在另一个，一个医生忽略了一项实验室检查，导致一患儿因严重感染住院。结果是：过量注射胰岛素的病例更容易被告知给患儿家属，而对实验室检查的忽视可能并没有第一个明显。
That may partly explain why 75% of pediatricians said they’d definitely report the insulin overdose to the child’s family, but only 33% said they’d definitely report the overlooked lab test. (It’s also worth noting that 89% rated the insulin overdose as a “serious error,” compared with 68% for the overlooked test.)
这个可能可以部分解释为什么75%的儿科医生说他们将对患儿过量注射胰岛素的事件会明确向家属告知，而只有33%的医生会将他们忽视了实验室检查明确告知家属。（值得一提的是有89%的医生将过量注射胰岛素定位为“严重失误”，而对忽视实验室检查的事件，只有68%的医生认为是“严重失误”。）
Those findings, published today in the Archives of Pediatrics and Adolescent Medicine, come from a survey of about 200 pediatricians conducted (confusingly enough) at the University of Washington in Seattle and Washington University in St. Louis.
该发现来自西雅图的华盛顿大学和圣.路易斯的华盛顿大学做得对200位儿科医生的调查。该结果发表于今天的Archives of Pediatrics and Adolescent Medicine杂志。
As the authors note, the findings here are similar to those among docs in other specialties. The wide range of responses about whether and how to report such errors to patients is reflective of a medical culture that is only slowly moving toward transparency, and of an abiding fear of lawsuits among doctors. (Several states do have laws on the books to give doctors some legal protection when they apologize for mistakes.)
就像作者提到的，该文提到的情况同样发生在其他专业的医生身上。对于是否，以及怎样向患者告知自己的错误上，不同的医生的行为方式各不相同。这反映了医学环境正由不透明向透明慢慢转变，同时也反映了医生对法律指控的普遍恐惧。（美国的一些州有相关法律对那些为自己的失误道歉的医生提供一些保护。）
"The bottom line is that the respondents tell about half of the truth rather than providing full disclosure," Wendy Levinson, chair of the Department of Medicine at the University of Toronto, writes in an accompanying editorial.
Wendy Levinson-多伦多大学医学部主任在编者按中写道：“这个问题的底线是：被告向患者告知了半数以上的实情，而不是等到事情全部败露。”
The culture does appear to be changing, however haltingly. The Joint Commission, which accredits hospitals, requires disclosure of medical errors that cause harm to patients. The New England Journal of Medicine published a paper last year describing some of the new programs emerging to help doctors report errors to patients.
这种大环境正在不断改变，尽管是慢慢进行的。这个结合点是患者对医院的信任要求医生将对患者有害的医疗错误告知与患者。新英格兰医学杂志去年登载了一篇论文，内容是关于帮助医生向患者告知自身失误的一些新方法或程序。
And, Levinson writes, her own hospital has used pretend patients (”standardized patients” in medical jargon) to give doctors a chance to practice explaining that they’ve made an error — the kind of conversation that, quite understandably, still makes many doctors uncomfortable.
同时，Levinson写道，她自己所在医院使用假装的病人（医学里行话叫做“标准化病人”）来给医生锻炼向患者解释自己所犯错误的机会。这种措施容易理解，因为这种对话总是让很多医生感觉不自在。
Talk Errors: Docs and nurses, do you always tell patients about medical errors? Visit the WSJ’s medicine community to discuss. (Subscribers only)
谈论错误：医生和护士们，你对自己医疗上的失误都会告诉病人吗？欢迎阅览WSJ医学社区讨论区。（只对注册用户开放） |
发表于 2008-10-9 13:26
发表于 2008-10-9 14:27
