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[在洛林地区的两家医院部署“手术室患者安全”检查表。成效与困难]

[Deployment of the checklist "Patient safety in the operating room" in two Lorraine hospitals. Performances and difficulties].

作者信息

Gueguen T, Coevoet V, Mougeot M, Pierron A, Blanquart D, Voicu M, Bouaziz H, Audibert G, Empereur F, Mertes P-M

机构信息

Département d'anesthésie-réanimation, hôpital Central, CHU de Nancy, 29 avenue du Maréchal-de-Lattre-de-Tassigny, Nancy, France.

出版信息

Ann Fr Anesth Reanim. 2011 Jun;30(6):489-94. doi: 10.1016/j.annfar.2011.04.006. Epub 2011 May 26.

Abstract

OBJECTIVE

To evaluate the implementation of the checklist HAS 2010 in two Lorraine health facilities to identify objectively brakes and levers to suggest possible improvements.

STUDY DESIGN

Descriptive survey.

MATERIAL AND METHODS

Operating rooms of the Neurosciences building Central University Hospital, Nancy, Belle-Isle Hospital participating public hospital service, Metz. Two stages: a retrospective audit allowed to objectify quantitatively the presence of CL in the patient record and monitor compliance with the instructions of filling. A survey by self-administered questionnaire to professionals to assess the use of CL.

RESULTS

CL was present in 50 % and 100 % records. The filling did not comply with instructions of the HAS (occupancy, three different times, time out before incision, stop the procedure if "no") and it was hard for about 30 % of participants, some items have problems of understanding. CL has strengthened information sharing about one third of respondents, over half of them are of interest, it has already helped to prevent errors. The deployment strategy influences directly the involvement of professionals. The evaluation of the use of CL cannot be done only through an audit record; the association with a self-administered questionnaire appears to be relevant.

CONCLUSION

Good adhesion to the concept, hope for better results after stock enhancement: optimize information and training of all professionals, avoid duplication with other documents. The audit record alone is not a good tool for evaluating the use of LBC, we must associate a self-administered questionnaire.

摘要

目的

评估2010年HAS检查表在洛林地区两家医疗机构的实施情况,以客观识别阻碍因素和推动因素,从而提出可能的改进建议。

研究设计

描述性调查。

材料与方法

南锡中央大学医院神经科学大楼的手术室、梅斯参与公共医疗服务的贝勒岛医院。分为两个阶段:回顾性审核能够定量客观地确定检查表在患者病历中的存在情况,并监测填写说明的遵守情况。通过向专业人员发放自填式问卷进行调查,以评估检查表的使用情况。

结果

检查表分别出现在50%和100%的病历中。填写不符合HAS的说明(占用情况、三个不同时间、切开前的暂停时间、如果“否”则停止手术),约30%的参与者感到困难,一些项目存在理解问题。检查表加强了约三分之一受访者之间的信息共享,其中超过一半的人对此感兴趣,它已经有助于预防错误。部署策略直接影响专业人员的参与度。对检查表使用情况的评估不能仅通过审核记录来完成;与自填式问卷相结合似乎是合适的。

结论

对该概念的良好接受度,在加强储备后有望取得更好的结果:优化所有专业人员的信息和培训,避免与其他文件重复。仅审核记录不是评估检查表使用情况的好工具,必须结合自填式问卷。

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