Arslan Zehra İpek, Ertargın Mehmet, Yavuz Cavit Işık, Yanal Hülya Yılmaz, Şenaylı Yeşim, Baykara Zehra Nur, Solak Mine
Department of Anaesthesiology and Reanimation, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Department of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2015 Aug;43(4):217-24. doi: 10.5152/TJAR.2015.30974. Epub 2015 Mar 3.
Every year, 230 million patients undergo major general surgery with anaesthesia worldwide, and 7 million resulted with major complications. Monitorisation and equipment has a great role in increasing patient safety and safe surgery during anaesthesia.
Turkey is divided into 12 Eurostut-NUTS regions and 26 subregions statistically. Totally, 303 hospitals that are included in these regions were enrolled in this descriptive trial. The hospitals were contacted by telephone between October 2012 and August 2013. Data collecting forms were e-mailed to any of the anaesthetists or anaesthesia technicians of the hospital and they were requested to fill the forms and forward them to one of the investigators.
Data were obtained from 221 of 303 hospitals (73%). Twenty-three hospitals were tertiary (university and education and research), 21 were city and 177 were county hospitals. No anaesthetist, operating rooms or intensive care units were available in 114 of the county hospitals. Anaesthetists were responsible for 61% of these active working theatres. Electrocardiogram, heart rate, non-invasive blood pressure and saturation could be monitored in 97% of them. End-tidal carbon dioxide could be monitored in 91% of at least one operating room in these hospitals. However, if the subject became to end-tidal carbon dioxide monitoring in every room, this ratio decreased to 63%. Defibrillators were absent in 6% of these rooms. Adult intensive care units were available in 33% of the hospitals and paediatric intensive care units were available in 32.4%; the responsibility of these intensive care units were carried out by anaesthetists at a 91.4% ratio. End-tidal carbon dioxide could be monitored in 54% of these units; invasive monitorisation could be applied in 68.4% if needed.
It was observed that hospitals have different standards according to their infrastructures of anaesthesia and intensive care unit equipment. We think that the elimination of these differences is an important step with respect to increasing patient safety and enhancement of the service quality in hospitals.
全球每年有2.3亿患者接受全身麻醉下的大手术，其中700万出现严重并发症。监测和设备在提高麻醉期间患者安全性及手术安全性方面发挥着重要作用。
从统计学角度将土耳其划分为12个欧洲统计局-统计区域单位（Eurostut-NUTS）地区和26个次区域。纳入这些区域的303家医院参与了此项描述性试验。2012年10月至2013年8月期间通过电话联系这些医院。将数据收集表通过电子邮件发送给医院的任何麻醉医生或麻醉技术人员，并要求他们填写表格后转发给其中一名研究人员。
从303家医院中的221家（73%）获取了数据。23家为三级医院（大学及教学和研究医院），21家为市级医院，177家为县级医院。114家县级医院没有麻醉医生、手术室或重症监护病房。麻醉医生负责这些活跃手术室中的61%。其中97%能够监测心电图、心率、无创血压和血氧饱和度。这些医院中91%的至少一个手术室能够监测呼气末二氧化碳。然而，如果每个房间都进行呼气末二氧化碳监测，该比例降至63%。这些房间中有6%没有除颤器。33%的医院设有成人重症监护病房，32.4%设有儿科重症监护病房；这些重症监护病房91.4%的工作由麻醉医生负责。这些病房中54%能够监测呼气末二氧化碳；如有需要，68.4%能够进行有创监测。
观察到不同医院的麻醉和重症监护病房设备基础设施存在不同标准。我们认为消除这些差异是提高患者安全性及提升医院服务质量的重要一步。
