Riddell A M, Charig M J
Department of Clinical Radiology, John Radcliffe Hospital, Headley Way, Oxford, UK.
Clin Radiol. 2002 Dec;57(12):1067-9. doi: 10.1053/crad.2002.1081.
To establish the current out of hours service provided in the United Kingdom for nephrostomy insertion.
Using the Royal College of Radiologists' (RCR) database a questionnaire was sent to all the current clinical directors.
Questionnaires were sent to 246 hospitals, with replies received from 178 (72.3%). The number of consultants doing nephrostomies as part of their routine work was 476; this increased to 625 including those who perform nephrostomies out of hours. Therefore 24% of consultants only perform nephrostomies out of hours. For the times when there was no formal out of hours nephrostomy service, the arrangements varied and included calling a consultant who was not on call (52%), or transferring the patient (37%). Only 19 hospitals (11%) had a separate interventional on call rota, the majority of these being teaching hospitals (68%). The availability of assistance was limited, with nursing staff available only 43% of the time. In institutions with specialist registrars, the registrars were involved with the nephrostomies 75% of the time.
There is a wide variation in the out of hours service provided by radiology departments for nephrostomy insertion. A large percentage of out of hours nephrostomies are done by consultants who do not perform do the procedure as part of their routine clinical practice, which is contrary to the advice of the Royal College of Radiologists for out of hours working. In addition the provision of nursing assistance for the procedure is inadequate.
确定英国目前提供的非工作时间肾造瘘术服务情况。
通过皇家放射科医师学院（RCR）数据库向所有现任临床主任发送问卷。
向246家医院发送了问卷，收到178份回复（72.3%）。将肾造瘘术作为日常工作一部分的顾问人数为476人；若包括非工作时间进行肾造瘘术的人员，这一数字增至625人。因此，24%的顾问仅在非工作时间进行肾造瘘术。对于没有正式非工作时间肾造瘘术服务的时段，安排各不相同，包括呼叫非值班顾问（52%）或转诊患者（37%）。只有19家医院（11%）有单独的介入值班轮班表，其中大多数是教学医院（68%）。可获得的协助有限，护理人员仅在43%的时间内可用。在有专科住院医师的机构中，住院医师参与肾造瘘术的时间为75%。
放射科提供的非工作时间肾造瘘术服务存在很大差异。很大一部分非工作时间的肾造瘘术由并非将该操作作为日常临床实践一部分的顾问进行，这与皇家放射科医师学院关于非工作时间工作的建议相悖。此外，该操作的护理协助不足。
