Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Kuopio University Hospital, Kuopio, Finland.
J Clin Nurs. 2018 Jan;27(1-2):288-305. doi: 10.1111/jocn.13896. Epub 2017 Dec 11.
To evaluate the impact of implementing an evidence-based, structured preoperative protocol on day of surgery cancellations in 13 operative specialties.
Surgery cancellations cause unnecessary harm for patients and organisations as many cancellations could be prevented. Preoperative care has developed in recent years, and several preoperative interventions have been introduced. However, the optimal model for organising preoperative care remains unknown. Cancellations are a commonly used indicator when evaluating the success of preoperative care.
Observational study with two study phases: before and after.
The cancellation data were collected from the hospital register from 1 September 2013-31 May 2014 (n = 591) and from September 2015-May 2016 (n = 542). The compliance rate of the preoperative protocol was evaluated in group sessions (n = 13) during spring 2016 using the participation of preoperative healthcare professionals (n = 49). The data were analysed statistically.
Cancellation rates varied between 1.6%-9.7% (in the first phase) and between 1.5%-7.7% (in the second phase). A remarkable decrease was found in patients who failed to attend their scheduled procedures. The mean of compliance to the preoperative protocol across all specialties was 82.3%. A correlation between the rate of cancellation and the rate of compliance with the preoperative protocol was found.
A preoperative protocol promotes the scheduled arrival of surgical patients to the hospital and therefore decreases cancellation rates.
An evidence-based preoperative care protocol should be introduced for all healthcare professionals working in preoperative care to ensure smooth, safe and high-quality care for surgical patients.
评估在 13 个手术专业中实施基于证据的结构化术前方案对手术当天取消手术的影响。
手术取消会给患者和医疗机构带来不必要的伤害，因为许多取消是可以预防的。近年来，术前护理已经发展起来，并且已经引入了几种术前干预措施。然而，组织术前护理的最佳模式仍不清楚。取消是评估术前护理成功的常用指标。
具有两个研究阶段的观察性研究：前后。
取消数据是从 2013 年 9 月 1 日至 2014 年 5 月 31 日（n=591）和 2015 年 9 月至 2016 年 5 月（n=542）从医院登记处收集的。2016 年春季，通过术前医疗保健专业人员（n=49）的参与，在小组会议上评估术前方案的遵守率。使用统计方法进行数据分析。
取消率在第一阶段为 1.6%-9.7%之间，在第二阶段为 1.5%-7.7%之间。未按时参加预定手术的患者的取消率显著下降。所有专业的术前方案平均遵守率为 82.3%。发现取消率与术前方案遵守率之间存在相关性。
术前方案促进了手术患者按时到达医院，从而降低了取消率。
所有从事术前护理的医疗保健专业人员都应引入基于证据的术前护理方案，以确保为手术患者提供顺利、安全和高质量的护理。
