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评估手术中浪费的一次性和可重复使用用品的成本。

Assessing the costs of disposable and reusable supplies wasted during surgeries.

机构信息

Department of Pharmacy, Nîmes University Hospital, Nîmes, France.

Department of Pharmacy, Nîmes University Hospital, Nîmes, France; Laboratory of Biostatistics, Epidemiology, Clinical Research and Health Economics, EA2415, University Institute of Clinical Research, Montpellier University, Montpellier, France.

出版信息

Int J Surg. 2018 May;53:18-23. doi: 10.1016/j.ijsu.2018.02.004. Epub 2018 Feb 9.

Abstract

BACKGROUND

The management of disposable and reusable supplies might have an impact on the cost efficiency of the Operating Room (OR). This study aimed to evaluate the cost and reasons for wasted supplies in the OR during surgical procedures.

METHODS

We conducted an observational and prospective study in a French university hospital. We assessed the cost of wasted supplies in the OR (defined by opened unused devices), the reasons for the wastage, and the circulator retrievals. At the end, we assessed the perception of surgeons and nurses relative to the supply wastage.

RESULTS

Fifty routine procedures and five non-scheduled procedures were observed in digestive (n = 20), urologic (n = 20) and gynecologic surgery (n = 15). The median cost [IQR] of open unused devices was €4.1 [0.5; 10.5] per procedure. Wasted supplies represented up to 20.1% of the total cost allocated to surgical supplies. Considering the 8000 surgical procedures performed in these three surgery departments, the potential annual cost savings were 100 000€. The most common reason of wastage was an anticipation of the surgeon's needs. The circulating nurse spent up to 26.3% of operative time outside of the OR, mainly attending to an additional demand from the surgeon (30%). Most of the survey respondents (68%) agreed that knowing supply prices would change their behavior.

CONCLUSIONS

This study showed the OR is a major source of wasted hospital expenditure and an area wherein an intervention would have a significant impact. Reducing wasted supplies could improve the cost efficiency of the OR and also decrease its ecological impact.

摘要

背景

一次性和可重复使用物品的管理可能会影响手术室的成本效益。本研究旨在评估手术过程中手术室(OR)中浪费物品的成本和原因。

方法

我们在一家法国大学医院进行了一项观察性和前瞻性研究。我们评估了 OR 中浪费物品的成本(定义为未使用的已打开设备)、浪费的原因以及巡回护士的回收情况。最后,我们评估了外科医生和护士对供应浪费的看法。

结果

观察了 50 例常规手术和 5 例非计划手术,涉及消化科(n=20)、泌尿科(n=20)和妇科手术(n=15)。每个手术过程中未使用的已打开设备的中位数成本[IQR]为 4.1 欧元[0.5;10.5]。浪费的供应品占分配给手术用品总成本的 20.1%。考虑到这三个手术部门进行了 8000 例手术,潜在的年度成本节约为 10 万欧元。浪费的最常见原因是外科医生需求的提前预估。巡回护士有高达 26.3%的手术时间在手术室外度过,主要是为了满足外科医生的额外需求(30%)。大多数受访者(68%)认为了解供应品价格会改变他们的行为。

结论

本研究表明,手术室是医院浪费支出的主要来源,也是一个可以产生重大影响的领域。减少浪费的供应品可以提高手术室的成本效益,同时减少其对环境的影响。

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