新生儿病房不良事件监测研究进展
Research Progress of Adverse Events Monitoring in Neonatal Ward
DOI: 10.12677/acm.2025.1551358, PDF,   
作者: 罗 颖, 华子瑜*:重庆医科大学附属儿童医院新生儿科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿童感染与免疫罕见病重庆市重点实验室,重庆
关键词: 新生儿不良事件监测人工智能Neonatal Adverse Events Monitor Artificial Intelligence
摘要: 医疗相关不良事件(Adverse healthcare-related events, AEs)不仅影响医疗质量,增加医疗成本,更会给患者及其家属造成伤害。新生儿因其特殊的生理特性,成为AE的高发人群,可能引起严重后果,甚至危及生命。当前AE监测手段可分为主动上报和被动监测,但均存在一定局限性,随着人工智能(Artificial Intelligence, AI)技术的发展,在提升医疗安全上展现出巨大潜力。本文旨在总结新生儿AE的发生率、常见类型与分类方式,分析新生儿易发生AE的原因,探讨现有监测手段及未来AI在新生儿病房AE监测的应用前景。
Abstract: Adverse healthcare-related events (AEs) significantly impact healthcare quality, increase costs, and harm patients and their families. Neonates, due to their unique physiological characteristics, are particularly susceptible to AEs, which can lead to severe consequences, including life-threatening situations. Current AEs monitoring methods, including active reporting and passive surveillance, both have limitations. Nowadays, advancements in Artificial Intelligence (AI) throw light on enhancing healthcare safety. This article aims to summarize the incidence, common types, and classification of neonatal AEs, analyze the reasons for their high occurrence in neonates, and explore existing monitoring methods along with the future prospects of AI in neonatal AEs surveillance.
文章引用:罗颖, 华子瑜. 新生儿病房不良事件监测研究进展[J]. 临床医学进展, 2025, 15(5): 188-194. https://doi.org/10.12677/acm.2025.1551358

参考文献

[1] World Health Organization (2023) Patient Safety.
https://www.who.int/news-room/fact-sheets/detail/patient-safety
[2] Slawomirski, L. and Klazinga, N. (2022) The Economics of Patient Safety: From Analysis to Action.
https://www.oecd-ilibrary.org/social-issues-migration-health/the-economics-of-patient-safety_761f2da8-en
[3] Alghamdi, A.A., Keers, R.N., Sutherland, A. and Ashcroft, D.M. (2019) Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review. Drug Safety, 42, 1423-1436. [Google Scholar] [CrossRef] [PubMed]
[4] Matlow, A.G., Cronin, C.M.G., Flintoft, V., Nijssen-Jordan, C., Fleming, M., Brady-Fryer, B., et al. (2011) Description of the Development and Validation of the Canadian Paediatric Trigger Tool. BMJ Quality & Safety, 20, 416-423. [Google Scholar] [CrossRef] [PubMed]
[5] Dillner, P., Unbeck, M., Norman, M., Nydert, P., Härenstam, K.P., Lindemalm, S., et al. (2023) Identifying Neonatal Adverse Events in Preterm and Term Infants Using a Paediatric Trigger Tool. Acta Paediatrica, 112, 1670-1682. [Google Scholar] [CrossRef] [PubMed]
[6] Salaets, T., Turner, M.A., Short, M., Ward, R.M., Hokuto, I., Ariagno, R.L., et al. (2019) Development of a Neonatal Adverse Event Severity Scale through a Delphi Consensus Approach. Archives of Disease in Childhood, 104, 1167-1173. [Google Scholar] [CrossRef] [PubMed]
[7] Salaets, T., Lacaze-Masmonteil, T., Hokuto, I., Gauldin, C., Taha, A., Smits, A., et al. (2023) Prospective Assessment of Inter-Rater Reliability of a Neonatal Adverse Event Severity Scale. Frontiers in Pharmacology, 14, Article 1237982. [Google Scholar] [CrossRef] [PubMed]
[8] Ostojic, D., Guglielmini, S., Moser, V., et al. (2023) Measuring Adverse Events in the Neonatal Intensive Care Units in Mit-Ghamr Central Hospital. The Egyptian Journal of Hospital Medicine, 92, 6395-6402.
[9] Sharek, P.J., Horbar, J.D., Mason, W., Bisarya, H., Thurm, C.W., Suresh, G., et al. (2006) Adverse Events in the Neonatal Intensive Care Unit: Development, Testing, and Findings of an Nicu-Focused Trigger Tool to Identify Harm in North American NICUs. Pediatrics, 118, 1332-1340. [Google Scholar] [CrossRef] [PubMed]
[10] Sakuma, M., Ohta, Y., Takeuchi, J., Yuza, Y., Ida, H., Bates, D.W., et al. (2023) Adverse Events in Pediatric Inpatients: The Japan Adverse Event Study. Journal of Patient Safety, 20, 38-44. [Google Scholar] [CrossRef] [PubMed]
[11] Fajreldines, A., Schnitzler, E., Torres, S., et al. (2019) Measurement of the Incidence of Care-Associated Adverse Events at the Department of Pediatrics of a Teaching Hospital. Archivos Argentinos de Pediatria, 117, e106-e109.
[12] Barrionuevo, L.S. and Esandi, M.E. (2010) Epidemiology of Adverse Events in the Neonatal Unit of a Regional Public Hospital in Argentina. Archivos Argentinos de Pediatria, 108, 303-310
[13] van den Anker, J., Reed, M.D., Allegaert, K. and Kearns, G.L. (2018) Developmental Changes in Pharmacokinetics and Pharmacodynamics. The Journal of Clinical Pharmacology, 58, S10-S25. [Google Scholar] [CrossRef] [PubMed]
[14] 宗亚玲, 丁洁, 程龙慧. 新生儿医院感染目标性监测[J]. 中国感染控制杂志, 2018, 17(11): 998-1002.
[15] World Health Organization (2024) Newborn Mortality.
https://www.who.int/news-room/fact-sheets/detail/newborn-mortality
[16] Carter, B.S. and Lantos, J.D. (2019) Disclosing Adverse Events and near Misses to Parents of Neonates. Seminars in Perinatology, 43, Article ID: 151182. [Google Scholar] [CrossRef] [PubMed]
[17] Murff, H.J., Patel, V.L., Hripcsak, G. and Bates, D.W. (2003) Detecting Adverse Events for Patient Safety Research: A Review of Current Methodologies. Journal of Biomedical Informatics, 36, 131-143. [Google Scholar] [CrossRef] [PubMed]
[18] Hibbert, P.D., Molloy, C.J., Hooper, T.D., Wiles, L.K., Runciman, W.B., Lachman, P., et al. (2016) The Application of the Global Trigger Tool: A Systematic Review. International Journal for Quality in Health Care, 28, 640-649. [Google Scholar] [CrossRef] [PubMed]
[19] Griffin, F.A. and Resar, R.K. (2009) IHI Global Trigger Tool for Measuring Adverse Events (Second Edition). Institute for Healthcare Improvement.
https://www.ihi.org/
[20] Sajith, S.G., Fung, D.S.S. and Chua, H.C. (2019) The Mental Health Trigger Tool: Development and Testing of a Specialized Trigger Tool for Mental Health Settings. Journal of Patient Safety, 17, e360-e366. [Google Scholar] [CrossRef] [PubMed]
[21] Brennan, T.A., Leape, L.L., Laird, N.M., Hebert, L., Localio, A.R., Lawthers, A.G., et al. (1991) Incidence of Adverse Events and Negligence in Hospitalized Patients: Results of the Harvard Medical Practice Study I. New England Journal of Medicine, 324, 370-376. [Google Scholar] [CrossRef] [PubMed]
[22] Stockwell, D.C., Kirkendall, E., Muething, S.E., Kloppenborg, E., Vinodrao, H. and Jacobs, B.R. (2013) Automated Adverse Event Detection Collaborative: Electronic Adverse Event Identification, Classification, and Corrective Actions across Academic Pediatric Institutions. Journal of Patient Safety, 9, 203-210. [Google Scholar] [CrossRef] [PubMed]
[23] Moor, M., Banerjee, O., Abad, Z.S.H., Krumholz, H.M., Leskovec, J., Topol, E.J., et al. (2023) Foundation Models for Generalist Medical Artificial Intelligence. Nature, 616, 259-265. [Google Scholar] [CrossRef] [PubMed]
[24] Robi, Y.G. and Sitote, T.M. (2023) Neonatal Disease Prediction Using Machine Learning Techniques. Journal of Healthcare Engineering, 2023, Article ID: 3567194. [Google Scholar] [CrossRef] [PubMed]
[25] Shalish, W., Kanbar, L.J., Rao, S., Robles-Rubio, C.A., Kovacs, L., Chawla, S., et al. (2017) Prediction of Extubation Readiness in Extremely Preterm Infants by the Automated Analysis of Cardiorespiratory Behavior: Study Protocol. BMC Pediatrics, 17, Article No. 167. [Google Scholar] [CrossRef] [PubMed]
[26] Ostojic, D., Guglielmini, S., Moser, V., Fauchère, J.C., Bucher, H.U., Bassler, D., et al. (2020) Reducing False Alarm Rates in Neonatal Intensive Care: A New Machine Learning Approach. In: Ryu, P.D., LaManna, J., Harrison, D. and Lee, S.S., Eds., Oxygen Transport to Tissue XLI, Springer, 285-290. [Google Scholar] [CrossRef] [PubMed]
[27] Gálvez, J.A., Jalali, A., Ahumada, L., Simpao, A.F. and Rehman, M.A. (2017) Neural Network Classifier for Automatic Detection of Invasive versus Noninvasive Airway Management Technique Based on Respiratory Monitoring Parameters in a Pediatric Anesthesia. Journal of Medical Systems, 41, Article No. 153. [Google Scholar] [CrossRef] [PubMed]
[28] Willan, J., Katz, H. and Keeling, D. (2019) The Use of Artificial Neural Network Analysis Can Improve the Risk‐Stratification of Patients Presenting with Suspected Deep Vein Thrombosis. British Journal of Haematology, 185, 289-296. [Google Scholar] [CrossRef] [PubMed]
[29] Dey, S., Luo, H., Fokoue, A., Hu, J. and Zhang, P. (2018) Predicting Adverse Drug Reactions through Interpretable Deep Learning Framework. BMC Bioinformatics, 19, Article No. 476. [Google Scholar] [CrossRef] [PubMed]