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改善骨科外科医生与放射技师在手术室的沟通。

Improving operating theatre communication between the orthopaedics surgeon and radiographer.

作者信息

Yeo Cheng Hong, Gordon Robert, Nusem Iulian

机构信息

Department of Orthopaedic Surgery, Toowoomba Hospital, Toowoomba, Queensland, Australia; Department of Orthopaedic Surgery, Logan Hospital, Meadowbrook, Queensland, Australia.

出版信息

ANZ J Surg. 2014 May;84(5):316-9. doi: 10.1111/ans.12482. Epub 2013 Dec 2.

DOI:10.1111/ans.12482
PMID:24299566
Abstract

OBJECTIVES

This study was designed to assess the importance of communication between surgeons and radiographers in the operation of image intensifiers during orthopaedic surgery.

METHODS

This study was designed and conducted as single-centre, observational study. Fifteen medical officers and 15 radiographers were involved in this study. Each of the 15 radiographers was assigned to a medical officer. The 15 pairs were then each given a task to simulate achieving 'perfect circles' on fluoroscopy for distal locking of an intramedullary nail. The time taken for the surgeon to verbally instruct the radiographer how to position the image intensifier in order to achieve 'perfect circles' was recorded. The overall time taken to perform the task, and total number of images taken was recorded before and after a terminology system to manoeuvre image intensifier was introduced to the pairs.

RESULTS

The mean time taken for the pairs to achieve perfect circles after the introduction of the manoeuvre terminology showed statistically significant reduction from 212 to 97 s (t = 4.212, df = 88, P < 0.05) after the introduction of the terminology. The mean number of fluoroscopy exposures taken also showed a statistically significant reduction from 12 to 6 (t = 6.791, df = 88, P < 0.05).

CONCLUSION

The implementation of a clear and unambiguous set of commands to control the image intensifier, which are common to both surgeon and radiographer, can reduce the time to acquire the desired images, and requires less radiation exposure in the process.

摘要

目的

本研究旨在评估骨科手术中外科医生与放射技师在影像增强器操作过程中沟通的重要性。

方法

本研究设计并开展为单中心观察性研究。15名医务人员和15名放射技师参与了本研究。15名放射技师每人被分配给一名医务人员。然后,这15对人员各自被赋予一项任务,即在荧光透视下模拟为髓内钉远端锁定实现“完美圆圈”。记录外科医生口头指导放射技师如何定位影像增强器以实现“完美圆圈”所需的时间。在向这几对人员引入用于操作影像增强器的术语系统之前和之后,记录执行任务的总时间以及拍摄的图像总数。

结果

引入操作术语后,这几对人员实现完美圆圈的平均时间从212秒显著减少至97秒(t = 4.212,自由度 = 88,P < 0.05)。荧光透视曝光的平均次数也显著减少,从12次降至6次(t = 6.791,自由度 = 88,P < 0.05)。

结论

实施一套清晰明确、外科医生和放射技师通用的控制影像增强器的指令,可以减少获取所需图像的时间,并且在此过程中减少辐射暴露。

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