在电子病历中实施新型活体供肾移植术前检查表：一项试点研究。
Implementation of a novel living-donor kidney transplant preoperative checklist within the electronic medical record: a pilot study.
作者信息
Gill Bradley C, Arora Hans C, Kerr Hannah R, Flechner Stuart M, Ellis Courtney D, Goldfarb David A
机构信息
Glickman Urological and Kidney Institute, Cleveland Clinic, Mail Stop Q10-1, 9500 Euclid Ave, Cleveland, OH 44195 USA ; Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH USA ; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH USA.
Glickman Urological and Kidney Institute, Cleveland Clinic, Mail Stop Q10-1, 9500 Euclid Ave, Cleveland, OH 44195 USA.
出版信息
Patient Saf Surg. 2015 Aug 19;9:28. doi: 10.1186/s13037-015-0074-5. eCollection 2015.
BACKGROUND
Checklist utilization in surgery has contributed to improved patient safety and reduced numbers of preventable complications. A living-donor kidney transplant (LDKT) preoperative checklist embedded within electronic medical record (EMR) was developed to enhance patient safety and prevent "never" events including: unexpected donor-recipient blood (ABO) incompatibility, positive (XM) cross match, infectious disease transmission, or procurement of an anatomically inappropriate allograft. Review of the initial 2 years of checklist utilization was performed.
FINDINGS
This safety instrument operates by facilitating critical review and referencing of source documentation to confirm ABO, XM, infectious risk, and organ anatomy compatibility. It was met with high compliance rates and no "never events" have occurred following its inception. The checklist is readily available in the EMR and is accessible by all members of the LDKT recipient healthcare team.
CONCLUSIONS
Checklist utilization was associated with zero LDKT "never event" occurrences. Surgeons felt the checklist was easy to use.
背景
手术中使用检查表有助于提高患者安全性并减少可预防并发症的数量。开发了一种嵌入电子病历（EMR）的活体供肾移植（LDKT）术前检查表，以提高患者安全性并预防“从未发生过”的事件，包括：供受者意外血型（ABO）不匹配、阳性（XM）交叉配型、传染病传播或获取解剖结构不合适的同种异体移植物。对检查表使用的最初两年进行了回顾。
研究结果
该安全工具通过促进对源文件的严格审查和参考来确认ABO、XM、感染风险和器官解剖兼容性。它的合规率很高，自启用以来未发生“从未发生过”的事件。检查表在EMR中随时可用，LDKT受者医疗团队的所有成员均可访问。
结论
检查表的使用与LDKT“从未发生过”的事件发生率为零相关。外科医生认为检查表易于使用。
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