국내 의료기관별 근접오류 발생 차이 및 투약 근접오류 영향요인

초록

This study aimed to examine differences in near-miss incidents across healthcare facility types over the past three years using patient safety statistics published by the Korea Institute for Healthcare Accreditation, systematically analyze factors associated with medication-related near misses, and provide evidence for developing tailored patient safety improvement strategies. Through this, the study sought to contribute to reducing potentially preventable patient safety incidents in the future. A total of 3,877 near-miss incidents occurring in hospitals, general hospitals, and tertiary hospitals from 2021 to 2023 were analyzed. Descriptive statistics were used for annual incidence frequencies, and chi-square tests with cross-tabulation analysis were conducted to examine differences in healthcare facility-related and patient-related characteristics across facility types. Binary logistic regression analysis was performed to identify factors associated with medication-related near misses. Medication errors accounted for 65.3% of all near misses, followed by laboratory tests (9.8%) and falls (5.6%). Incident locations were inpatient units (34.5%), outpatient clinics (29.9%), and pharmacies (10.8%), with 68.4% occurring during day shifts. The most common patient age group was 60-79 years (32.9%), and internal medicine was the most frequent department (28.6%). Analysis of factors associated with medication-related near misses revealed that tertiary hospitals had 3.209 times higher odds (95% CI: 2.040-5.048) compared to hospitals, outpatient clinics had 2.650 times higher odds (95% CI: 1.870-3.756), and inpatient units had 2.482 times higher odds (95% CI: 2.033-3.030). By department, pediatrics showed 10.924 times higher odds (95% CI: 4.457-26.774) and internal medicine showed 4.157 times higher odds (95% CI: 3.134-5.516) compared to orthopedics. Medication-related near misses showed higher risk in tertiary hospitals, outpatient clinics and inpatient units, and pediatrics and internal medicine departments. Tailored patient safety management strategies are needed that consider healthcare facility type, incident location, and department characteristics.

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