Smith A F, Mort M, Goodwin D, Pope C
Department of Anaesthesia Institute for Health Research, Lancaster University, Lancaster, LA1 4YT, UK.
Anaesthesia. 2003 Nov;58(11):1070-8. doi: 10.1046/j.1365-2044.2003.03404.x.
This study aimed to explore the use of electronic monitoring within the context of anaesthetic practice. We conducted workplace observation of, and interviews with, anaesthetists and other anaesthetic staff in two UK hospitals. Transcripts were analysed inductively for recurrent themes. Whilst formal sources of knowledge in anaesthesia deal with the issue of monitoring in terms of theoretical principles and performance specifications of devices, anaesthetists in practice often 'disbelieve' monitoring information. They call on and integrate other sources of knowledge about the patient, especially from their clinical assessment. The ability to distinguish 'normal' and 'abnormal' findings is vital. Confidence in electronic information varies with experience, as does the degree to which electronic information may be considered 'redundant'. We conclude that electronic monitoring brings new dimensions of understanding but also the potential for new ways of misunderstanding. The tacit knowledge underlying the safe use of monitoring deserves greater acknowledgement in training and practice.
本研究旨在探讨电子监测在麻醉实践中的应用。我们对英国两家医院的麻醉医生及其他麻醉工作人员进行了工作场所观察和访谈。对访谈记录进行归纳分析以找出反复出现的主题。虽然麻醉领域的正规知识来源从理论原则和设备性能规格方面论述了监测问题，但实际操作中的麻醉医生常常“怀疑”监测信息。他们会借助并整合有关患者的其他知识来源，尤其是来自临床评估的信息。区分“正常”和“异常”结果的能力至关重要。对电子信息的信任程度因经验而异，电子信息被认为“多余”的程度也是如此。我们得出结论，电子监测带来了新的理解维度，但也存在产生新的误解方式的可能性。安全使用监测背后的隐性知识在培训和实践中应得到更多认可。
