Milby A, Böhmer A, Gerbershagen M U, Joppich R, Wappler F
Medical School, University Witten/Herdecke, Witten, Germany.
Acta Anaesthesiol Scand. 2014 Feb;58(2):192-7. doi: 10.1111/aas.12249. Epub 2013 Dec 20.
Anaesthesiology plays a key role in promoting safe perioperative care. This includes the perioperative phase in the post-anaesthesia care unit (PACU) where problems with incomplete information transfer may have a negative impact on patient safety and can lead to patient harm. The objective of this study was to analyse information transfer during post-operative handovers in the PACU.
With a self-developed checklist including 59 items the information transfer during post-operative handovers was documented and subsequently compared with patient information in anaesthesia records during a 2-month period.
A total number of 790 handovers with duration of 73 ± 49 s was analysed. Few items were transferred in most of the cases such as type of surgery (97% of the cases), regional anaesthesia (94% of the cases) and cardiac instability (93% of the cases). However, some items were rarely transferred, such as American Society of Anesthesiologists physical status (7% of the cases), initiation of post-operative pain management (12% of the cases), antibiotic therapy (14% of the cases) and fluid management (15% of the cases). There was a slight correlation between amount of information transferred and duration of post-operative handovers (r = 0.5).
The study shows that post-operative handovers in the PACU are in most cases incomplete. It appears useful to optimise the post-operative handover process, for example by implementing a standardised handover checklist.
麻醉学在促进围手术期安全护理方面发挥着关键作用。这包括麻醉后护理单元(PACU)的围手术期阶段,在此阶段,信息传递不完整的问题可能会对患者安全产生负面影响,并可能导致患者受到伤害。本研究的目的是分析PACU术后交接班期间的信息传递情况。
使用一份自行编制的包含59项内容的清单,记录术后交接班期间的信息传递情况,随后在两个月的时间内将其与麻醉记录中的患者信息进行比较。
共分析了790次交接班,持续时间为73±49秒。在大多数情况下,很少有项目被交接,如手术类型(97%的病例)、区域麻醉(94%的病例)和心脏不稳定(93%的病例)。然而,一些项目很少被交接,如美国麻醉医师协会身体状况分级(7%的病例)、术后疼痛管理的启动(12%的病例)、抗生素治疗(14%的病例)和液体管理(15%的病例)。交接的信息量与术后交接班持续时间之间存在轻微相关性(r = 0.5)。
该研究表明,PACU的术后交接班在大多数情况下是不完整的。优化术后交接班流程似乎是有用的,例如通过实施标准化的交接清单。