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清单对麻醉后患者交接质量的影响:一项随机对照试验。

The effect of a checklist on the quality of post-anaesthesia patient handover: a randomized controlled trial.

机构信息

Clinic and Policlinic of Anaesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.

出版信息

Int J Qual Health Care. 2013 Apr;25(2):176-81. doi: 10.1093/intqhc/mzt009. Epub 2013 Jan 29.

Abstract

OBJECTIVE

Patient handover is an important element of continuity, quality and safety in patient care. Handover without standardized protocols is prone to information loss and might be a possible danger to patient safety. Checklists are established methods that help to structure complex processes in other high-risk fields such as aviation. In the past few years, their implementation has attracted research interest in medicine. We hypothesize that a checklist for handover between anaesthesiologist and post-anaesthesia care unit nurse will increase the amount of information transfer during patient handover after anaesthesia.

DESIGN AND SETTING

A total of 120 post-anaesthesia patient handovers were recorded on video and analyzed. Forty handovers before the implementation of the checklist and 80 after the implementation of the checklist, randomized into two groups: with and without the use of the checklist.

MAIN OUTCOME MEASURES

An overall number of items handed over, handover of specific items and duration of the handover were analyzed.

RESULTS

With the use of the written checklist, the overall items handed over increased significantly from a median of 32.4-48.7%. The duration of handover increased from a median of 86-121 s. Instructions about items that should be included in handovers, but without the use of a written checklist, was not associated with an increase in the number of items handed over or duration of the interview.

CONCLUSIONS

This study suggests that the use of a checklist for post-anaesthesia handover might improve the quality of patient handover by increasing the information handed over.

摘要

目的

患者交接是患者护理连续性、质量和安全的重要组成部分。没有标准化协议的交接容易导致信息丢失,可能对患者安全构成潜在危险。清单是一种既定的方法,有助于在航空等其他高风险领域组织复杂的流程。在过去的几年中,它们的实施引起了医学界的研究兴趣。我们假设,麻醉师与麻醉后护理单元护士之间交接的清单将增加麻醉后患者交接期间的信息传递量。

设计和设置

总共记录了 120 次麻醉后患者交接情况,并进行了视频分析。在清单实施前记录了 40 次交接,在清单实施后记录了 80 次交接,随机分为两组:使用清单和不使用清单。

主要观察指标

分析总体交接项目数、特定项目交接和交接持续时间。

结果

使用书面清单后,总体交接项目数从中位数 32.4-48.7%显著增加。交接持续时间从中位数 86-121 秒增加。关于交接中应包含的项目的说明,但没有使用书面清单,与交接项目数量或访谈持续时间的增加无关。

结论

本研究表明,使用麻醉后交接清单可能通过增加交接信息来提高患者交接质量。

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