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救命的核对表 – 译学馆
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救命的核对表

The life saving power of checklists

2001年 在澳大利亚
In Australia, in 2001,
3岁女孩意外掉入冰窟之中
a three-year-old girl accidentally fell into an icy pond.
令人惊诧的是
There she became lost
女孩在冰面下消失了整整半个小时
beneath the surface for an incredible half an hour.
在被发现之后
And by the time she was found,
已没有了脉搏
she had no pulse,
人体核心温度只有18度
and her core temperature was only 18 degrees.
而且眼睛对光没有任何反应
Furthermore, her eyes didn’t react to light,
这意味着大脑也失去运作能力
indicating that her brain wasn’t functioning either.
然而一个外科医生团队试图抢救她
Yet, a team of surgeons tried to save her.
其中一项复杂步骤便是
As part of their complex procedure,
先用电锯将女孩的胸腔切成两半
they would firstly crack her chest in half using a power saw.
看起来就像这样
This would have looked something like this.
接着医生会将她的心脏
Then they would connect her heart
与体外膜肺氧合系统相连接
to a extracorporeal membrane oxygenation system,
这一系统为心肺提供动力支持
a unit which provides support to both the heart and lungs.
但这还不够
But, that wasn’t all.
接着他们在头骨处钻洞
Later on, they drew the hole into a skull
以监控和调节脑压
to monitor and adjust her cerebral pressures.
总而言之 女孩昏迷了一周左右
All in all, she was in comma for about a week.
但令人惊诧的是 在事故后的仅两周之后
Yet, amazingly only two weeks after her accident,
医院就准许女孩回家
she was allowed to go home.
两个月后身体完全恢复正常
And after twenty months, she was completely back to normal.
医生将女孩从濒死边缘拉回
It’s miraculous that doctors could save her
就是一项奇迹
from such a near-death experience.
但糟糕的是 事情不会总那么顺利
Unfortunately, things don’t always go as well.
正如你所猜想的一样
As you can guess,
医学操作流程非常复杂
these medical procedures are incredibly complex
事故总会发生
and mistakes happen all the time.
事实上 据估计
In fact it’s estimated that
每年都有2百到1万人因医疗事故死亡
medical errors kill between 200 and 10,000
单就美国而言人数已达4.4万人
and 440,000 people per year in America alone.
这是继心脏病和癌症之后
This makes it the third leading cause of death,
致人死亡的第三大死因
following heart disease and cancer.
另一项研究表明在重症监护病房
Another study found out that within the intensive care units,
每天每人接受的医疗操作
medical starts performed on average
约有178项
178 actions per patient per day.
令人惊诧的是 所犯错误只占
Now surprisingly, they only made a mistake
全部操作的1%
one percent of the time.
但这仍意味着
Yet, this still equates to about
每天每个病人会出现两个致命错误
two severe errors per patient per day.
重点在于这些任务很复杂
The point is because these tasks are so complex.
犯错误是极其容易的
It’s very easy to make a mistake.
因此 人们做了什么来弥补这一状况?
So what have people done to remedy the situation?
一种解决办法便是使用核对表
One solution has been to use a checklist.
你并不指望如此简单的事情会起作用
Now you wouldn’t expect something so simple to work.
但它的效果却出乎意料
But it’s surprisingly effective.
一项由世界卫生组织的研究表明
In one study by the World Health Organization,
手术核对表在八个城市的
a surgery checklist was implemented
八家不同的医院实施启用
in eight different hospitals, in eight different cities.
这些条目也并非首创
These items weren’t anything groundbreaking either.
仅是那些检查过敏症
Just stuff like checking for allergies,
检查仪器处无菌状态
checking that the equipment is sterile,
以及核对病人身份的事项也要使用核对表
and confirming the patient’s identity.
但此项干预却使死亡人数降低47%
Yet, the intervention led to a 47% decrease in deaths.
这也意味着重大术后并发症的
It also meant the 36 percent decrease
发病率降低了36%
in major post surgical complications.
很难相信核对表竟如此奏效
It’s hard to believe that the checklist could work that well.
事实上 许多医生非常抗拒使用核对表
In fact, many doctors are actively resisting to use of checklist,
认为这是浪费时间的操作
claiming it to be a waste of time.
完全可以理解
This is understandable.
如洗手之类的条目似乎很醒目
Items like washing your hands, seems so obvious.
但或许这便是核对表如此重要的原因
But perhaps this is why checklists are so important.
随着其它事项的同步进行
With so many other things going on,
医生极易忽略一些基本步骤
it’s very easy to overlook these basic steps,
随后的研究发现
Later studies have found that
完成核对表的条目越多
the more of the checklists teams completed,
并发症的几率越低
the lower the rate of complications.
另外 在应用于医学之前
Now, before all of this,
核对表早被应用于多样的领域之中
checklists were already used in a varity of fields
如航空 车间安全以及软件工程等领域
like aviation, workplace safety and software engineering.
但在见证了其在手术方面的成功以后
But now, after seeing its success in surgery, too,
人们便试图将核对表
people have been tryingt to expand
扩展应用于更多的领域之中
the use of checklists into more domains.
例如诺奖获得者心理学家丹尼尔·卡内曼
For example, Nobel Prize winning psychologist Daniel Kahneman
建议在作商业决策的时候使用
has suggested using the checklist of twelve cognitive biases,
12种认知偏见的核对表
when making a business decision.
包括当人们忽略矛盾性证据的时候
This includes checking for things like confirmation bias,
会确认的诸如确认偏误等的事项
which is when people ignore conflicting evidence.
这些错误并非不为人所知
Now, it’s not like these errors aren’t known by people.
而是我们不会经常想起它们
It’s just that we’re not always aware of them.
因此核对表会促使人们
So here, a checklist would force people
在作出重大决策的时候
to switch to a more rational mindset,
转为更加理性的心态
when making a big decision.
现在 澄清一下
Now, just to be clear,
没有实验证明
there is no experiments that have tested
是否核对表用于日常生活有没有作用
if checklists would work in a more day-to-day situation.
但是 它似乎一定会在繁琐工作中有所裨益
However, it definitely seems to help with complex tasks.
你会将核对表应用于生活中的哪些方面?
So, where can you apply checklists in your life?

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视频概述

奇迹!为医生点赞!

听录译者

徘徊的小孩

翻译译者

小多荷

审核员

审核员YZ

视频来源

https://www.youtube.com/watch?v=KvrNEnwOCE0

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