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在单诱导室至单手术室设置中决定顺畅流程和非手术时间的因素。

Factors determining the smooth flow and the non-operative time in a one-induction room to one-operating room setting.

作者信息

Mulier Jan P, De Boeck Liesje, Meulders Michel, Beliën Jeroen, Colpaert Jan, Sels Annabel

机构信息

Department of Anesthesiology, Intensive Care and Reanimation, Department of Anesthesiology, AZ Sint-Jan Brugge-Oostende, Bruges, Belgium; Department of Cardiovascular Sciences, Anesthesiology and Algology, KU Leuven, Leuven, Belgium.

出版信息

J Eval Clin Pract. 2015 Apr;21(2):205-14. doi: 10.1111/jep.12288. Epub 2014 Dec 11.

Abstract

RATIONALE, AIMS AND OBJECTIVES: What factors determine the use of an anaesthesia preparation room and shorten non-operative time?

METHODS

A logistic regression is applied to 18 751 surgery records from AZ Sint-Jan Brugge AV, Belgium, where each operating room has its own anaesthesia preparation room. Surgeries, in which the patient's induction has already started when the preceding patient's surgery has ended, belong to a first group where the preparation room is used as an induction room. Surgeries not fulfilling this property belong to a second group. A logistic regression model tries to predict the probability that a surgery will be classified into a specific group. Non-operative time is calculated as the time between end of the previous surgery and incision of the next surgery. A log-linear regression of this non-operative time is performed.

RESULTS

It was found that switches in surgeons, being a non-elective surgery as well as the previous surgery being non-elective, increase the probability of being classified into the second group. Only a few surgery types, anaesthesiologists and operating rooms can be found exclusively in one of the two groups. Analysis of variance demonstrates that the first group has significantly lower non-operative times. Switches in surgeons, anaesthesiologists and longer scheduled durations of the previous surgery increases the non-operative time. A switch in both surgeon and anaesthesiologist strengthens this negative effect. Only a few operating rooms and surgery types influence the non-operative time.

CONCLUSION

The use of the anaesthesia preparation room shortens the non-operative time and is determined by several human and structural factors.

摘要

原理、目的与目标:哪些因素决定麻醉准备室的使用并缩短非手术时间?

方法

对来自比利时AZ Sint-Jan Brugge AV的18751份手术记录应用逻辑回归分析,该医院每个手术室都有自己的麻醉准备室。在前一位患者手术结束时患者诱导已经开始的手术属于第一组,其中准备室用作诱导室。不满足此条件的手术属于第二组。逻辑回归模型试图预测手术被分类到特定组的概率。非手术时间计算为上一台手术结束到下一台手术切开皮肤之间的时间。对该非手术时间进行对数线性回归分析。

结果

发现外科医生更换、手术为非择期以及上一台手术为非择期会增加被分类到第二组的概率。仅少数手术类型、麻醉医生和手术室仅出现在两组中的一组。方差分析表明第一组的非手术时间显著更短。外科医生、麻醉医生的更换以及上一台手术预定时间更长会增加非手术时间。外科医生和麻醉医生都更换会强化这种负面影响。仅少数手术室和手术类型影响非手术时间。

结论

麻醉准备室的使用缩短了非手术时间,且由若干人为和结构因素决定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e65d/4406160/65e1c0438947/jep0021-0205-f1.jpg

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