Soria-Aledo Víctor, Da Silva ZeNewton Andre, Saturno Pedro J, Grau-Polan Marina, Carrillo-Alcaraz Andrés
Cirugía General y del Aparato Digestivo, Servicio de Cirugía General, Hospital General Universitario Morales Meseguer, Murcia, España.
Cir Esp. 2012 Mar;90(3):180-5. doi: 10.1016/j.ciresp.2011.09.007. Epub 2012 Feb 11.
To assess the level of implementation and the factors associated with the compliance to the surgical check list (SCL) proposed by the WHO, in surgery departments in public hospitals in the Murcia Region of Spain.
A retrospective cross-sectional study was conducted using a random, non-proportional, and stratified sample in each hospital. The sample size was established as 10 cases per centre, with a total of 90 surgical operations. The data analysis included the percentage of compliance of the variables of interest (presence of an SCL and the compliance to it, complete, by sections and by items) at regional level, according to hospital, hospital groups, depending on the size; the type of anaesthesia (local, regional or general); the work shift (morning or afternoon); as well as the age and sex of the surgery patients.
The check list was found in the medical records in 75 cases (83.33%; confidence interval [CI]: 78.7% - 87.5%), and complied with in full in 25 cases (27.8%; 95% CI: 18.5% - 37.0%). The percentage of items complied with was 70.1% (95% CI: 67.9%-72.2%). The percentage compliance varied by hospital, from 35.8% to 98.9%. The logistic regression analysis showed significance in the variables such as, the size of the hospital (the list was more likely to be complied with in small and medium hospitals) and operations with local anaesthetic as a negative predictive factor of compliance.
The SCL is used, but is not always complied with, and not homogeneously in all its sections. There is also significant variation between the public hospitals in the Murcia Region of Spain.
评估西班牙穆尔西亚地区公立医院外科科室对世界卫生组织提出的手术核查表（SCL）的执行水平及与之相关的依从因素。
采用回顾性横断面研究，在每家医院抽取随机、非比例且分层的样本。样本量确定为每个中心10例病例，共90例外科手术。数据分析包括按医院、医院组（根据规模）、麻醉类型（局部、区域或全身）、工作班次（上午或下午）以及手术患者的年龄和性别，在区域层面上分析感兴趣变量（SCL的存在及其依从性，按章节和项目完整情况）的依从百分比。
75例病例（83.33%；置信区间[CI]：78.7% - 87.5%）的病历中有核查表，25例病例（27.8%；95% CI：18.5% - 37.0%）完全依从。项目依从百分比为70.1%（95% CI：67.9% - 72.2%）。依从百分比因医院而异，从35.8%至98.9%不等。逻辑回归分析显示，医院规模（中小型医院更有可能依从该表）以及局部麻醉手术作为依从性的负性预测因素等变量具有统计学意义。
SCL虽被使用，但并非总是得到依从，且各章节的依从情况不均一。西班牙穆尔西亚地区的公立医院之间也存在显著差异。
