Wheeler Derek S, Sheets Anna M, Ryckman Frederick C
Divisions of Critical Care Medicine, Patient Services, and Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Departments of Pediatrics and Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Transl Pediatr. 2018 Oct;7(4):299-307. doi: 10.21037/tp.2018.09.09.
Transitions of care between individual providers or teams of providers have a high potential for errors due to the incomplete transfer of critical information and the need for ongoing care. The transition from the operating room (OR) to the intensive care unit (ICU) is a particularly dangerous time for critically ill children. Hand-offs of care between the OR and ICU teams during this key transition period require detailed communication of complete and accurate patient information at a time when the patient is perhaps most vulnerable from a physiologic standpoint. Improving the safety of transitions from the OR to the ICU is an active area of investigation, though there are a few notable best practices that are commonly employed in a number of centers. These best practices include having the appropriate personnel at the bedside for the hand-off, the use of scripts and the "sterile cockpit rule", the use of checklists, double verification of post-operative orders, and maintaining an overall safety culture.
由于关键信息传递不完整以及持续护理的需求，个体医疗服务提供者或医疗团队之间的护理交接存在很高的出错可能性。对于危重症儿童而言，从手术室（OR）到重症监护病房（ICU）的过渡是一个特别危险的时期。在这个关键过渡阶段，手术室和重症监护病房团队之间的护理交接需要在患者生理上可能最为脆弱的时候详细沟通完整准确的患者信息。提高从手术室到重症监护病房过渡的安全性是一个活跃的研究领域，不过一些中心通常采用一些值得注意的最佳实践。这些最佳实践包括安排合适的人员在床边进行交接、使用脚本和“无菌驾驶舱规则”、使用检查表、对术后医嘱进行双重核查以及维持整体安全文化。
