《安全第一》：儿科麻醉检查表的设计
«Safety First»: Design of an anesthetic checklist in pediatrics.
作者信息
Eizaga Rebollar R, García Palacios M V, Fernández Mangas M C, Arroyo Fernández F J, Márquez Rodríguez C M, Carnota Martín A I, Morales Guerrero J, Torres Morera L M
机构信息
Servicio de Anestesiología y Reanimación, Hospital Universitario Puerta de Mar, Cádiz, España.
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Puerta de Mar, Cádiz, España.
出版信息
Rev Esp Anestesiol Reanim (Engl Ed). 2019 Nov;66(9):459-466. doi: 10.1016/j.redar.2019.06.007. Epub 2019 Sep 30.
INTRODUCTION
Quality improvement in health care entails the design of reliable processes which prevent and mitigate medical errors. Checklists are cognitive tools which reduce such errors. The primary objective of this study was to design an anesthetic checklist in Pediatrics to be implemented in our hospital.
METHODS
Delphi technique was used, with 3 rounds of questionnaire surveys: a generic questionnaire to obtain dimensions and items; and 2 specific ones to score individual items and obtain an overall rating for the checklist (median), and to measure the level of consensus (relative interquartile range) and internal reliability (Wilcoxon signed-rank test).
RESULTS
Final version of the checklist obtained a high overall score (Med 9) with a very high consensus (RIR 5%). Internal consensus was reached on all items (RIR ≤ 30%). Wilcoxon signed-rank test found no statistically significant differences, demonstrating reliability or consistency of responses between consecutive rounds.
CONCLUSION
The Anesthetic checklist in Pediatrics has been methodically designed for implementation and use in our hospital.
引言
医疗保健中的质量改进需要设计可靠的流程，以预防和减少医疗差错。检查表是减少此类差错的认知工具。本研究的主要目的是设计一份儿科麻醉检查表，以便在我院实施。
方法
采用德尔菲技术，进行三轮问卷调查：一份通用问卷以获取维度和项目；另外两份特定问卷用于对各个项目进行评分，并获得检查表的总体评分（中位数），测量共识水平（相对四分位距）和内部信度（Wilcoxon符号秩检验）。
结果
检查表的最终版本获得了较高的总体评分（中位数9）和非常高的共识（相对四分位距5%）。所有项目均达成内部共识（相对四分位距≤30%）。Wilcoxon符号秩检验未发现统计学上的显著差异，表明连续几轮之间的回答具有可靠性或一致性。
结论
儿科麻醉检查表已进行了系统设计，以便在我院实施和使用。
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