Department of Ophthalmology, Western Eye Hospital, London, UK.
Department of Anaesthetics and Intensive Care, Kingston Hospital, London, UK.
Postgrad Med J. 2018 Mar;94(1109):143-150. doi: 10.1136/postgradmedj-2016-134559. Epub 2017 Nov 9.
Use of the WHO surgical safety checklist is consistently recognised to reduce harm caused by human error during the perioperative period. Inconsistent engagement is considered to contribute to persistence of surgical Never Events in the National Health Service. Most medical and nursing graduates will join teams responsible for the perioperative care of patients, therefore appropriate undergraduate surgical safety training is needed.
To investigate UK medical and nursing undergraduate experience of the surgical safety checklist training.
An eight-item electronic questionnaire was distributed electronically to 32 medical schools and 72 nursing schools. Analysis was conducted for the two cohorts, and responses from final year students were included.
87/224 (38.8%) of medical students received teaching on the surgical safety checklist, compared with 380/711 (52.0%) of nursing students. 172/224 (76.8%) of medical students and 489/711 (66.9%) of nursing students understood its purpose and 8/224 (3.6%) medical students and 54/711 (7.4%) nursing students reported never being included in the Time Out. After adjusting for confounding factors, provision of formal teaching in checklist use increased understanding significantly (OR 50.39 (14.07 to 325.79, P<0.001)), as did routine student involvement in time outs (OR 5.72 (2.36 to 14.58, P<0.001)).
Knowledge of perioperative patient safety systems and the ability to participate in safety protocols are important skills that should be formally taught at the undergraduate level. Results of this study show that UK undergraduate surgical safety checklist training does not meet the minimum standards set by the WHO.
使用世界卫生组织手术安全检查表被一致认为可以减少围手术期人为错误造成的伤害。参与度不一致被认为是导致国家卫生服务中外科手术“不应发生的事件”持续存在的原因。大多数医学和护理专业的毕业生将加入负责围手术期患者护理的团队,因此需要进行适当的本科手术安全培训。
调查英国医学生和护生对手术安全检查表培训的体验。
向 32 所医学院和 72 所护理学院发放了一份八项内容的电子问卷。对两个队列进行了分析,并纳入了应届毕业生的回答。
87/224(38.8%)名医学生接受了手术安全检查表教学,而 380/711(52.0%)名护理学生接受了教学。172/224(76.8%)名医学生和 489/711(66.9%)名护理学生理解其目的,8/224(3.6%)名医学生和 54/711(7.4%)名护理学生报告从未参与过“暂停时间”。在调整混杂因素后,检查表使用的正式教学显著增加了理解(OR 50.39(14.07 至 325.79,P<0.001)),学生常规参与“暂停时间”也增加了理解(OR 5.72(2.36 至 14.58,P<0.001))。
了解围手术期患者安全系统和参与安全协议的能力是重要的技能,应在本科阶段进行正式教学。本研究结果表明,英国本科手术安全检查表培训不符合世界卫生组织设定的最低标准。