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专用的微创手术套房提高了手术室效率。

Dedicated minimally invasive surgery suites increase operating room efficiency.

作者信息

Kenyon T A, Urbach D R, Speer J B, Waterman-Hukari B, Foraker G F, Hansen P D, Swanström L L

机构信息

Department of Minimally Invasive Surgery, Legacy Health Systems, Emanuel Hospital, 2801 N. Gantenbein Ave., Portland, OR 97227, USA.

出版信息

Surg Endosc. 2001 Oct;15(10):1140-3. doi: 10.1007/s004640080092. Epub 2001 Jul 5.

Abstract

BACKGROUND

The rapid adoption of laparoscopic surgery since the late 1980s added tremendous complexity into the operating room (OR) environment. For each case, a plethora of additional equipment-including monitors, video equipment, wiring, tubing, and cords-had to be set up, prolonging OR turnover time and decreasing OR efficiency. In 1993, the concept of designated minimally invasive surgery (MIS) suites was introduced. MIS suites integrated monitors and video equipment into the OR on ceiling-mounted columns and moved the controls to a centralized nursing station. The overall effect of this innovation on OR efficiency has not been measured.

METHODS

Five RNs with varying degrees of MIS experience were instructed on video setup and put-away criteria and then timed while performing a set of standardized tasks. Each set of tasks was performed twice using a standardized surgery model. Differences in setup and put-away times between MIS suites and standard ORs were tested using the t-test for paired comparisons.

RESULTS

The mean +/- standard deviation (SD) video setup times were 27.9 +/- 5.3 sec (MIS) and 254.3 +/- 54.0 sec (standard); the put-away times were 19.8 +/- 2.7 sec (MIS) and 222.3 +/- 26.0 sec (standard). The mean difference +/- standard error (SE) in both the setup (226.4 +/- 16.9 sec, p = 0.0001) and put-away times (202.5 +/- 8.6, p = 0.0001) were large and statistically significant.

CONCLUSION

Using a simulation model, we have demonstrated that the use of a MIS suite reduces video setup and put-away time significantly, with the potential for significant associated cost savings. This provides just one justification for the high cost of building such "ORs of the future."

摘要

背景

自20世纪80年代末以来,腹腔镜手术的迅速普及给手术室环境带来了极大的复杂性。对于每一台手术,都需要安装大量额外的设备,包括监视器、视频设备、电线、管道和线缆,这延长了手术室的周转时间,降低了手术室效率。1993年,引入了指定的微创手术(MIS)套房的概念。MIS套房将监视器和视频设备集成到手术室天花板上的立柱上,并将控制装置移至中央护理站。这一创新对手术室效率的总体影响尚未得到评估。

方法

对5名具有不同程度MIS经验的注册护士进行视频设备安装和整理标准的培训,然后让他们在执行一组标准化任务时进行计时。每组任务使用标准化手术模型进行两次。使用配对比较的t检验来测试MIS套房和标准手术室在设备安装和整理时间上的差异。

结果

平均±标准差(SD)的视频设备安装时间分别为27.9±5.3秒(MIS套房)和254.3±54.0秒(标准手术室);整理时间分别为19.8±2.7秒(MIS套房)和222.3±26.0秒(标准手术室)。设备安装时间(226.4±16.9秒,p = 0.0001)和整理时间(202.5±8.6秒,p = 0.0001)的平均差异±标准误(SE)都很大且具有统计学意义。

结论

通过模拟模型,我们证明了使用MIS套房可显著减少视频设备的安装和整理时间,并有可能大幅节省相关成本。这只是建设此类“未来手术室”成本高昂的一个理由。

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