Xiao Yan, Dexter Franklin, Hu Peter, Dutton Richard P
Department of Anesthesiology and Program in Trauma, University of Maryland, Baltimore, USA.
Anesth Analg. 2008 Feb;106(2):554-60, table of contents. doi: 10.1213/ane.0b013e3181606f01.
On the day of surgery, real-time information of both room occupancy and activities within the operating room (OR) is needed for management of staff, equipment, and unexpected events.
A status display system showed color OR video with controllable image quality and showed times that patients entered and exited each OR (obtained automatically). The system was installed and its use was studied in a 6-OR trauma suite and at four locations in a 19-OR tertiary suite. Trauma staff were surveyed for their perceptions of the system.
Evidence of staff acceptance of distributed OR video included its operational use for >3 yr in the two suites, with no administrative complaints. Individuals of all job categories used the video. Anesthesiologists were the most frequent users for more than half of the days (95% confidence interval [CI] >50%) in the tertiary ORs. The OR charge nurses accessed the video mostly early in the day when the OR occupancy was high. In comparison (P < 0.001), anesthesiologists accessed it mostly at the end of the workday when occupancy was declining and few cases were starting. Of all 30-min periods during which the video was accessed in the trauma suite, many accesses (95% CI >42%) occurred in periods with no cases starting or ending (i.e., the video was used during the middle of cases). The three stated reasons for using video that had median surveyed responses of "very useful" were "to see if cases are finished," "to see if a room is ready," and "to see when cases are about to finish."
Our nurses and physicians both accepted and used distributed OR video as it provided useful information, regardless of whether real-time display of milestones was available (e.g., through anesthesia information system data).
在手术当天,手术室(OR)的房间占用情况和室内活动的实时信息对于人员、设备管理以及应对突发事件至关重要。
一种状态显示系统可展示手术室彩色视频,图像质量可控,并能自动显示患者进出各手术室的时间。该系统已安装,并在一个拥有6间手术室的创伤治疗套房以及一个拥有19间手术室的三级套房中的四个地点进行了使用研究。对创伤治疗团队的工作人员就他们对该系统的看法进行了调查。
工作人员接受分布式手术室视频的证据包括,该系统在这两个套房中已投入使用超过3年,且无管理方面的投诉。所有工作类别的人员都使用了该视频。在三级手术室中,超过半数的日子里(95%置信区间[CI]>50%),麻醉医生是最频繁的使用者。手术室收费护士大多在手术室占用率高的当天早些时候查看视频。相比之下(P<0.001),麻醉医生大多在工作日结束时,即占用率下降且很少有新手术开始时查看视频。在创伤治疗套房中,在查看视频的所有30分钟时间段里,许多查看行为(95%CI>42%)发生在没有手术开始或结束的时间段(即视频在手术过程中被使用)。使用视频的三个被调查者中位数回答为“非常有用”的原因是“查看手术是否结束”、“查看房间是否准备好”以及“查看手术何时即将结束”。
我们的护士和医生都接受并使用了分布式手术室视频,因为它提供了有用的信息,无论是否有里程碑事件的实时显示(例如,通过麻醉信息系统数据)。