Connor Matthew P, Dion Gregory R, Borgman Matthew, Maturo Stephen
Department of Otolaryngology, San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
Department of Otolaryngology, San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
Int J Pediatr Otorhinolaryngol. 2014 Dec;78(12):2165-8. doi: 10.1016/j.ijporl.2014.10.002. Epub 2014 Oct 18.
As financial pressures drive health care to be more cost-effective and efficient, performing procedures outside the main operating room (MOR) is becoming more common. Pediatric sedation units (PSU) have proven both effective and safe at providing anesthesia for children. However, there is limited data available regarding the PSU and its potential application in pediatric otolaryngology.
To evaluate the experience of performing pediatric outpatient procedures in a PSU through a parental satisfaction survey.
Pediatric otolaryngology procedures performed in the PSU were prospectively recorded in a database. A prospective survey analysis was performed that measured parental satisfaction with scheduling/registration for surgery, nursing care, surgeon care, facility environment, timing/duration, and overall satisfaction. Parents completed this survey for outpatient procedures performed in either the PSU or in the MOR. The same attending surgeon was involved in all cases, with the only independent variable being the location of the surgery. Fifty surveys were collected for each group, and the surveys scores were statistically compared using nonparametric statistical analysis.
Parental satisfaction was high in both the PSU and OR, with mean overall satisfaction scores of 4.8 and 4.9 (respectively) on an ordinal scale from 1 to 5. Parents reported greater clarity in preoperative information in the MOR (mean 4.8) compared to the PSU (mean 4.6) (p<0.006). Also, parents reported that MOR procedures started on time more often than those in the PSU (90-64%, p<0.002). There were no significant differences between locations in any other survey metrics, with mean satisfaction scores ranging from 4.5 to 5.0.
The PSU is a satisfactory patient experience for outpatient procedures in pediatric otolaryngology at our institution. However, this parent survey has identified education prior to surgery and timeliness of surgery as two areas to improve to meet the satisfaction standard provided by the OR.
随着经济压力促使医疗保健更具成本效益和效率,在主手术室(MOR)以外的地方进行手术变得越来越普遍。儿科镇静单元(PSU)已被证明在为儿童提供麻醉方面既有效又安全。然而,关于PSU及其在小儿耳鼻喉科的潜在应用的数据有限。
通过家长满意度调查评估在PSU进行小儿门诊手术的经验。
在数据库中前瞻性记录在PSU进行的小儿耳鼻喉科手术。进行了一项前瞻性调查分析,测量家长对手术安排/登记、护理、外科医生护理、设施环境、时间/时长以及总体满意度的满意度。家长对在PSU或MOR进行的门诊手术完成此项调查。所有病例均由同一位主治外科医生参与,唯一的自变量是手术地点。每组收集50份调查问卷,并使用非参数统计分析对调查得分进行统计学比较。
PSU和手术室(OR)的家长满意度都很高,在1至5的有序量表上,总体满意度平均得分分别为4.8和4.9。与PSU(平均4.6)相比,家长报告在MOR术前信息更清晰(平均4.8)(p<0.006)。此外,家长报告MOR手术比PSU手术更经常按时开始(90%-64%,p<0.002)。在任何其他调查指标中,不同地点之间没有显著差异,平均满意度得分在4.5至5.0之间。
在我们机构,PSU对于小儿耳鼻喉科门诊手术来说是一次令人满意的患者体验。然而,这项家长调查已将术前教育和手术及时性确定为需要改进的两个方面,以达到手术室提供的满意度标准。