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在一所三级学术中心实施手术安全核对表:对安全文化和患者结局的影响。

Implementation of the surgical safety checklist at a tertiary academic center: Impact on safety culture and patient outcomes.

作者信息

Zingiryan Areg, Paruch Jennifer L, Osler Turner M, Hyman Neil H

机构信息

Department of Medicine, Temple University Hospital, Philadelphia, PA, USA.

Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.

出版信息

Am J Surg. 2017 Aug;214(2):193-197. doi: 10.1016/j.amjsurg.2016.10.027. Epub 2016 Nov 30.

Abstract

BACKGROUND

The impact and efficacy of the World Health Organization Surgery Safety Checklist (SSC) is uncertain. We sought to determine if the SSC decreases complications and examined the attitudes of the surgical team members following implementation of the SSC.

METHODS

A 28-question survey was developed to assess perspectives of surgical team members at the University of Vermont Medical Center (UVMC). The University Health System Consortium database was examined to compare the rates of nine complications before and after SSC implementation using Chi square analysis and Fisher's exact test.

RESULTS

There was no significant decrease in any of the nine complications 2 years after SSC implementation. There was overall agreement that the SSC improved communication, safety, and prevented errors in the operating room. However, there was disagreement between nursing and surgeons over whether all three parts of the SSC were always completed.

CONCLUSIONS

Implementation of the SSC did not result in a significant decrease in perioperative morbidity or mortality. However, it did improve the perception of safety culture by operating room staff.

摘要

背景

世界卫生组织手术安全核对表(SSC)的影响和效果尚不确定。我们试图确定SSC是否能减少并发症,并在实施SSC后检查手术团队成员的态度。

方法

设计了一份包含28个问题的调查问卷,以评估佛蒙特大学医学中心(UVMC)手术团队成员的观点。利用卡方分析和费舍尔精确检验,对大学卫生系统联盟数据库进行检查,以比较SSC实施前后九种并发症的发生率。

结果

实施SSC两年后,九种并发症中的任何一种均未显著减少。总体上大家一致认为,SSC改善了手术室的沟通、安全性并防止了错误。然而,护士和外科医生在SSC的所有三个部分是否都始终得到完成这一问题上存在分歧。

结论

实施SSC并未导致围手术期发病率或死亡率显著降低。然而,它确实改善了手术室工作人员对安全文化的认知。

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