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Проучване мнението на медицинските специалисти относно управлението на рискови случаи в болнични отделения

Мариана Белова, Любомира Kоева-Димитрова


Introduction: To increase patient safety, not only is the analysis of mistakes needed, but also the timely identification, registration, analysis and management of emerging risk cases and critical incidents that could lead to errors.

Aim: The purpose of the study is to present the results of a survey conducted on the opinion of various medical specialists on the factors responsible for risk cases and mistakes in their medical practice.

Materials and Methods: We have used scientific publications on risk-recording systems, and patient safety; developed questionnaire; opinion of doctors, nurses, midwives working in different wards of hospitals in Varna. The methods used are: content analysis, statistical methods, and sociological methods.

Results: Poor working conditions and inability to work in a team are among the most frequently cited reasons for critical incidents that can lead to mistakes. Overwhelming conditions, stress and the lack of sufficient staff are also considered important factors for admission of risk cases. Collaboration and good communication at all levels are also important to managing risk cases and minimizing critical incidents, according to the medical professionals. Years of experience contribute to the minimization of mistakes during work, but the fear of change can lead to a lack of sharing among colleagues, and this has a negative impact on risk management.

Conclusion: Safe medical care is a priority in the studied wards. The timely identification, registration and analysis of risk cases that can lead to a serious incident reduce the probability of their admission again. The introduction of a modern system for reporting and analyzing critical incidents would significantly improve the management of risk cases as well as patient safety. This will improve the quality of work in the wards and the prestige of the medical establishment.


risk factors; critical incident; risk management; patient safety; medical mistakes

Full Text


An Organization with a Memory: Report of an Expert Group on Learning From Adverse Events in the NHS, Crown Copyright. 2000

Baker, G. R. and P. Norton. Making Patients Safer! Reducing Error in Canadian Healthcare. Healthcare Papers. 2001; (1): 10-31

Building a Safer System: A National Integrated Strategy for Improving Patient Safety in Canadian Health Care, 2002

Conklin, A., A-M. Vilamovska, H. Vries, E. Hatziandreu. Improving Patient Safety in the EU. RAND Corporation. 2008

Haig, K., S. Sutton, J. Whittington. SBAR: A Shared Mental Model for Improving Communication Between Clinicians. Journal on Quality and Patient Safety. 2006; 32 (3): 167-175

Leape, L. Error in medicine. The Journal of American Medicine. 1994; Volume 272, number 23, page 1851(7)

Nolan, T. W. System changes to improve patient safety. 2000; BMJ 320 (18 March): 771-773

Null, G., C. Dean, M. Feldman, D. Rasio, D. Smith. Death by Medicine. 2003

Reason, J. Human Error. New York, NY: Cambridge University Press. 1990

Reason, J. Human error: models and management. 2000; BMJ 320: 768-770.

Reason, J. T. Achieving a safe culture: theory and practice. Work and Stress. 1998; 12(3): 293-306.

Reason, J. T. Managing the Risks of Organizational Accidents. Aldershot, England: Ashgate Publishing. 1997

Reinertsen, J. Let`s Talk About Error. 2000; BM 320: 730

Sexton, J. B., E. J. Thomas, et al. Error, stress, and teamwork in medicine and aviation: cross sectional surveys. 2000; BMJ 320 (7237): 745-9

Singh, H., A. Dinkar Naik, R. Rao, L.A. Petersen. Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology. J Gen Intern Med. 2007; 23(4): 489-94

Wilson RM, Runciman WB, Gibberd RW, et al. The Quality in Australian Health Care Study. 1995; 163: 458- 471.

Thompson, A.M., P.A. Stonebridge. Building a framework for trust: critical event analysis of deaths in surgical care. 2005; BMJ 330: 1139-1142

US National Library of Medicine National Institute of Health. Rados [Internet]. C. Drug Name Confusion: Preventing Medication Errors. 2005 Jul-Aug; 39(4): 35-7; Available from:

Vincent, C. Framework for analyzing risk and safety in clinical medicine. 1998; BMJ 316:1154-7

Weingart, S.N ., R. McL. Wilson, R. W. Gibberd, B. Harrison. Epidemiology of medical error. 2000; BMJ 320 (7237), 774-777

Wu, A.W., S Folkman39, S J McPhee and B Lo. Do house officers learn from their mistakes? J1991; AMA 265: 2089-2094

Wilson RM, Michel P, Olsen S, et al; WHO Patient Safety EMRO/AFRO Working Group. Patient safety in developing countries; retrospective estimation of scale and nature of harm to patients in hospital. 2012; 344: e832. Doi: 10.1136/bmj.e832.

The Medical Journal of Australia. John D. Hamilton, Robert W Gibbert, Bernadette T Harrison. After the Quality in Australian Health Care Study, what happened? Aug 2014; 201 (1): 23. Doi: 10.5694/mja.00615

Попова, М. Концептуален модел за изграждане на система за безопасност на на пациентите в лечебните заведения за болнична помощ. Дисертация за придобиване на ОНС „Доктор“, МУ-София. 2012.

Петрова, Зл., „Критерии за лекарска или медицинска грешка в търсене на консенсусно определение”, (Internet);; 2016.


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