一份简单的术中检查表对腹腔镜新手任务表现的影响。
The effect of a simple intraprocedural checklist on the task performance of laparoscopic novices.
作者信息
El Boghdady Michael, Tang Benjie, Tait Iain, Alijani Afshin
机构信息
Cuschieri Skills Centre, Ninewells Hospital and Medical School, University of Dundee, Level 5, Dundee, UK.
Cuschieri Skills Centre, Ninewells Hospital and Medical School, University of Dundee, Level 5, Dundee, UK.
出版信息
Am J Surg. 2017 Aug;214(2):373-377. doi: 10.1016/j.amjsurg.2016.07.019. Epub 2016 Aug 16.
BACKGROUND
Surgical checklists are used for error reduction. Checklists are infrequently applied during procedures and have been limited to lists of procedural steps as aid memoires. We aimed to study the effect of a self-administered checklist on the laparoscopic task performance of novices during a standardized task.
METHODS
Twenty novices were randomized into 2 equal groups, those receiving paper feedback (control group) and those receiving paper feedback and the checklist (checklist group). Subjects performed laparoscopic double knots, repeated over 5 separate stages. Human reliability assessment technique was used for error analysis.
RESULTS
2,341 errors were detected during the 5 stages. During the first stage, the errors were not significantly different between the 2 groups. The checklist group committed significantly fewer errors as compared with the control group during all the later 4 stages (P < .01).
CONCLUSIONS
The simple intraprocedural checklist significantly improved the laparoscopic task performance and the learning curve of laparoscopic novices.
背景
手术核对表用于减少差错。核对表在手术过程中使用频率不高，且一直局限于作为辅助记忆的手术步骤清单。我们旨在研究自我管理的核对表对新手在标准化任务中腹腔镜操作表现的影响。
方法
20名新手被随机分为两组，一组接受纸质反馈（对照组），另一组接受纸质反馈和核对表（核对表组）。受试者进行腹腔镜双重打结操作，分5个不同阶段重复进行。采用人因可靠性评估技术进行差错分析。
结果
在5个阶段共检测到2341个差错。在第一阶段，两组差错无显著差异。在随后的4个阶段，核对表组的差错明显少于对照组（P <.01）。
结论
简单的术中核对表显著提高了腹腔镜操作表现以及腹腔镜新手的学习曲线。
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