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评估加拿大门诊手术机构的患者安全:一项全国性调查。

Assessing patient safety in Canadian ambulatory surgery facilities: A national survey.

作者信息

Ahmad Jamil, Ho Olivia A, Carman Wayne W, Thoma Achilles, Lalonde Donald H, Lista Frank

机构信息

The Plastic Surgery Clinic, Mississauga;

Division of Plastic and Reconstructive Surgery, University of Toronto;

出版信息

Plast Surg (Oakv). 2014 Spring;22(1):34-8.

Abstract

BACKGROUND

There has been increased interest regarding patient safety and standards of care in Canadian ambulatory surgery facilities where surgical procedures are performed. The Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF) is a national organization formed to establish and maintain standards to ensure that surgical procedures conducted outside of public hospitals are performed safely.

OBJECTIVE

To determine how many procedures are performed annually at CAAASF member sites, and to examine complication rates and several key patient safety practices.

METHODS

All 69 facilities accredited by the CAAASF were surveyed. The survey focused on procedural data, complication rates and patient safety interventions.

RESULTS

In 2010, 40,240 estimated procedures were performed. A total of 263 (0.007%) complications were reported. Sixteen (0.0004%) patients required reoperations in hospital and 19 (0.0004%) patients required transfer to hospital on the day of surgery. There were only two mortalities within 30 days of surgery reported in the past five years. With regard to patient safety practices, 93% used antimicrobial prophylaxis, 100% used strategies to maintain normothermia and 82% used measures for venous thromboembolism prevention.

CONCLUSION

The present study is the first to report on the Canadian experience in ambulatory surgery facilities and provides insight into current practices at these facilities. Appropriate accreditation of ambulatory surgery facilities, well-established patient safety-related standards of care, careful patient selection and procedures performed by qualified health care professionals with appropriate certification practicing within the scope of their practice form the basis for safe and effective ambulatory surgery.

摘要

背景

在加拿大进行外科手术的门诊手术设施中,人们对患者安全和护理标准的关注度日益提高。加拿大门诊手术设施认证协会(CAAASF)是一个全国性组织,其成立目的是制定和维持标准,以确保在公立医院以外进行的外科手术安全实施。

目的

确定CAAASF成员机构每年实施的手术数量,并检查并发症发生率和一些关键的患者安全措施。

方法

对CAAASF认证的所有69家机构进行了调查。调查重点是手术数据、并发症发生率和患者安全干预措施。

结果

2010年,估计共实施了40240例手术。共报告了263例(0.007%)并发症。16例(0.0004%)患者需要在医院再次手术,19例(0.0004%)患者在手术当天需要转院。过去五年中,仅报告了2例术后30天内死亡病例。在患者安全措施方面,93%使用了抗菌预防措施,100%使用了维持正常体温的策略,82%使用了预防静脉血栓栓塞的措施。

结论

本研究首次报告了加拿大门诊手术设施的情况,并深入了解了这些设施的当前做法。门诊手术设施的适当认证、完善的与患者安全相关的护理标准、仔细的患者选择以及由具有适当资质且在其执业范围内执业的合格医疗保健专业人员实施手术,构成了安全有效的门诊手术的基础。

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