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在印度一家教学医院实施世界卫生组织手术安全核对表并评估其对围手术期并发症的影响。

Implementation of the WHO Surgical Safety Checklist at a teaching hospital in India and evaluation of the effects on perioperative complications.

作者信息

Shankar Raghavendra

机构信息

Department of Orthopaedics, Rajarajeswari Medical College and Hospital, Bangalore, India.

出版信息

Int J Health Plann Manage. 2018 Oct;33(4):836-846. doi: 10.1002/hpm.2533. Epub 2018 Apr 20.

DOI:10.1002/hpm.2533
PMID:29675898
Abstract

BACKGROUND

The WHO Surgical Safety Checklist was developed to help operating teams reduce the occurrence of patient harm. The Checklist is a simple, practical tool that any surgical team in the world can use to ensure that the preoperative, intraoperative, and postoperative steps that have been shown to benefit patients are undertaken in a timely and efficient way.

METHODS

This study was carried out at Rajarajeswari Medical College Hospital, Bangalore, India, to study the effects of the WHO Surgical Safety Checklist on mortality and morbidity in surgical patients, to identify the potential problems in the long-term implementation of the same, and to document the complications in patients undergoing a major surgery during the study period. Data collection followed patients prospectively until discharge or for 30 days, whichever came first, for complications and death.

RESULTS

There were a total of 73 complications during the period of the study (4.1%). Of these, more than half (44) were surgical wound infections. The proportion of patients who received prophylactic antibiotics was 100% during the period of the study and the checklist identified a deficit and corrected the same in 27 patients.

CONCLUSIONS

The checklist was successfully implemented in the said hospital, and the appropriate processes were studied. The use of the checklist was successful in drawing the attention of the personnel to the issue of patient safety, its magnitude, and the appropriate steps to be taken in this regard. The number of omissions in the operation rooms was significantly reduced.

摘要

背景

世界卫生组织手术安全核对表旨在帮助手术团队减少患者伤害的发生。该核对表是一个简单、实用的工具,全球任何手术团队都可用来确保已证明对患者有益的术前、术中和术后步骤能及时、高效地执行。

方法

本研究在印度班加罗尔的拉贾拉杰斯瓦里医学院医院开展,以研究世界卫生组织手术安全核对表对手术患者死亡率和发病率的影响,确定长期实施该核对表存在的潜在问题,并记录研究期间接受大手术患者的并发症情况。前瞻性地收集患者数据,直至出院或30天(以先到者为准),记录并发症和死亡情况。

结果

研究期间共有73例并发症(4.1%)。其中,超过一半(44例)为手术伤口感染。研究期间接受预防性抗生素治疗的患者比例为100%,核对表发现并纠正了27例患者的不足。

结论

该核对表在上述医院成功实施,并对适当流程进行了研究。核对表的使用成功地使工作人员关注到患者安全问题、其严重性以及在这方面应采取的适当措施。手术室中的遗漏数量显著减少。

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