Jonnalagadda R, Walrond E R, Hariharan S, Walrond M, Prasad C
Department of Surgery, Queen Elizabeth Hospital, Barbados, West Indies.
Int J Clin Pract. 2005 Jun;59(6):716-20. doi: 10.1111/j.1742-1241.2004.00354.x.
Data on all patients scheduled to have elective and emergency surgeries during the period of 6 weeks from September 1999 to October 1999 were prospectively collected to determine scheduled starting times, actual starting times, completion times, causes for delays and cancellations. Of 840 procedures scheduled during the study period, 594 (71%) were available for analysis. Eighty-nine per cent of cancellations occurred in patients undergoing elective surgery. The common causes of cancellations were non-availability of beds in recovery room (RR) (15%), patients not showing up (9%), improper pre-operative patient preparation (13%), unavailability of nurses (11%) and anaesthetists (8%). Twenty-three per cent of the cancellations were day cases. Public patients were cancelled more frequently than private patients. Surgical procedures started on time in only 7% of patients. The most common cause of delay was due to delayed transport of patients to the operating theatre (17%). Optimal utilisation of operating theatres in our situation may be effected by increasing the bed-strength of ICUs to free the RR, proper pre-operative work up, adequate counselling of day-care surgery patients and efficient floor management of the operating theatre.
前瞻性收集了1999年9月至1999年10月这6周内所有计划进行择期和急诊手术患者的数据，以确定预定开始时间、实际开始时间、完成时间、延迟和取消的原因。在研究期间计划进行的840例手术中，594例（71%）可供分析。89%的取消发生在接受择期手术的患者中。取消的常见原因包括恢复室（RR）没有床位（15%）、患者未到场（9%）、术前患者准备不当（13%）、护士（11%）和麻醉师（8%）无法到位。23%的取消是日间手术病例。公立患者比私立患者更频繁地被取消手术。只有7%的患者手术按时开始。最常见的延迟原因是患者转运至手术室延迟（17%）。在我们这种情况下，通过增加重症监护病房的床位以腾出恢复室、进行适当的术前检查、对日间手术患者进行充分的咨询以及对手术室进行有效的楼层管理，可能会实现手术室的最佳利用。
