Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Institute of Quality Assurance and Patient Safety, Radboud University Medical Center, Nijmegen, The Netherlands.
BMJ Open. 2017 Dec 14;7(12):e018367. doi: 10.1136/bmjopen-2017-018367.
This study was carried out to improve patient safety in the operating theatre by the introduction of perioperative briefing and debriefing, which focused on an optimal collaboration between surgical team members.
A prospective intervention study with one pretest and two post-test measurements: 1 month before and 4 months and 2.5 years after the implementation of perioperative briefing and debriefing, respectively.
Operating theatres of a tertiary care hospital with 875 beds in the Netherlands.
All members of five surgical teams participated in the perioperative briefing and debriefing.
The implementation of perioperative briefing and debriefing from July 2012 to January 2014.
The primary outcome was changes in the team climate, measured by the Team Climate Inventory. Secondary outcomes were the experiences of surgical teams with perioperative briefing and debriefing, measured with a structured questionnaire, and the duration of the briefings, measured by an independent observer.
Two and a half years after the introduction of perioperative briefing and debriefing, the team climate increased statistically significant (p≤0.05). Members of the five surgical teams strongly agreed with the positive influence of perioperative briefing and debriefing on clear agreements and reminding one another of the agreements of the day. They perceived a higher efficiency of the surgical programme with more operations starting on time and less unexpectedly long operation time. The perioperative briefing took less than 4 min to conduct.
Perioperative briefing and debriefing improved the team climate of surgical teams and the efficiency of their work within the operating theatre with acceptable duration per briefing. Surgical teams with alternating team compositions have the most benefit of briefing and debriefing.
本研究旨在通过引入围手术期简报和讨论,重点关注手术团队成员之间的最佳协作,提高手术室的患者安全。
一项前瞻性干预研究,有一个预测试和两个后测试测量:分别在围手术期简报和讨论实施前 1 个月和实施后 4 个月和 2.5 年进行。
荷兰一家拥有 875 张床位的三级护理医院的手术室。
五名手术团队的所有成员都参加了围手术期简报和讨论。
从 2012 年 7 月到 2014 年 1 月实施围手术期简报和讨论。
主要结果是团队氛围的变化,通过团队氛围调查问卷进行测量。次要结果是手术团队对围手术期简报和讨论的体验,通过结构化问卷进行测量,以及简报的持续时间,由独立观察员进行测量。
围手术期简报和讨论实施 2.5 年后,团队氛围显著增加(p≤0.05)。五名手术团队的成员强烈同意围手术期简报和讨论对明确协议和提醒彼此当天的协议产生了积极影响。他们认为手术计划的效率更高,更多的手术按时开始,意外的手术时间更短。围手术期简报的持续时间不到 4 分钟。
围手术期简报和讨论改善了手术团队的团队氛围,并提高了手术室工作的效率,简报的持续时间可以接受。具有交替团队组成的手术团队从简报和讨论中受益最大。