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错误和严重事件与疝气修补结果有关吗?

Do errors and critical events relate to hernia repair outcomes?

作者信息

Law Forsyth Katherine, DiMarco Shannon M, Jenewein Caitlin G, Ray Rebecca D, D'Angelo Anne-Lise D, Cohen Elaine R, Wiegmann Douglas A, Pugh Carla M

机构信息

University of Wisconsin-Madison, School of Engineering, Department of Industrial and Systems Engineering, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA.

University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.

出版信息

Am J Surg. 2017 Apr;213(4):652-655. doi: 10.1016/j.amjsurg.2016.11.020. Epub 2016 Nov 17.

Abstract

BACKGROUND

The study aimed to validate an error checklist for simulated laparoscopic ventral hernia (LVH) repair procedures. We hypothesize that residents' errors can be assessed with a structured checklist and the results will correlate significantly with procedural outcomes.

METHODS

Senior residents' (N = 7) performance on a LVH simulator were video-recorded and analyzed using a human error checklist. Junior residents (N = 38) performed two steps of the same simulated LVH procedure. Performance was evaluated using the error checklist and repair quality scores.

RESULTS

There were no significant differences between senior and junior residents' checklist errors (p > 0.1). Junior residents' errors correlated with hernia repair quality (p = 0.05).

CONCLUSIONS

The newly developed assessment tool showed significant correlations between performance errors, critical events, and hernia repair quality. These results provide validity evidence for the use of errors in performance assessments.

SUMMARY

This study validated an error checklist for simulated laparoscopic ventral hernia (LVH) repair procedures. The checklist was designed based on errors committed by chief surgery residents during LVH repairs. In a separate data collection, junior residents were evaluated using the checklist. Hernia repair quality was also assessed. Errors significantly correlated with hernia repair quality (p = 0.05).

摘要

背景

本研究旨在验证一份用于模拟腹腔镜腹疝(LVH)修补手术的差错清单。我们假设,可以使用结构化清单评估住院医师的差错,且结果将与手术结果显著相关。

方法

对高级住院医师(N = 7)在LVH模拟器上的操作进行视频记录,并使用人为差错清单进行分析。初级住院医师(N = 38)进行相同模拟LVH手术的两个步骤。使用差错清单和修补质量评分对操作进行评估。

结果

高级和初级住院医师在清单差错方面无显著差异(p > 0.1)。初级住院医师的差错与疝修补质量相关(p = 0.05)。

结论

新开发的评估工具显示,操作差错、关键事件和疝修补质量之间存在显著相关性。这些结果为在绩效评估中使用差错提供了有效性证据。

总结

本研究验证了一份用于模拟腹腔镜腹疝(LVH)修补手术的差错清单。该清单基于主刀住院医师在LVH修补过程中所犯的差错设计。在另一项数据收集工作中,使用该清单对初级住院医师进行评估。同时也评估了疝修补质量。差错与疝修补质量显著相关(p = 0.05)。

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