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患者和医护人员对手术患者安全清单的建议 - 一项定性研究。

Patients' and healthcare workers' recommendations for a surgical patient safety checklist - a qualitative study.

机构信息

Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway.

Department of Anesthesia and Intensive Care, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway.

出版信息

BMC Health Serv Res. 2020 Jan 16;20(1):43. doi: 10.1186/s12913-020-4888-1.

Abstract

BACKGROUND

Patients' involvement in patient safety has increased in healthcare. Use of checklists may improve patient outcome in surgery, though few have attempted to engage patients' use of surgical checklist. To identify risk elements of complications based on patients' and healthcare workers' experiences is warranted. This study aims to identify what the patients and healthcare workers find to be the risk elements that should be included in a patient-driven surgical patient safety checklist.

METHOD

A qualitative study design where post-operative patients, surgeons, ward physicians, ward nurses, and secretaries from five surgical specialties took part in focus group interviews. Eleven focus groups were conducted including 25 post-operative patients and 27 healthcare workers at one tertiary teaching hospital and one community hospital in Norway. Based on their experiences, participants were asked to identify perceived risks before and after surgery. The interviews were analysed using content analysis.

RESULTS

Safety risk factors were categorised as pre-operative information: pre-operative preparations, post-operative information, post-operative plans and follow-up. The subcategories under pre-operative information and preparations were: contact information, medication safety, health status, optimising health, dental status, read information, preparation two weeks before surgery, inform your surgical ward, planning your own discharge, preparation on admission and just before surgery. The subcategories under post-operative information, further plans and follow-up were: prevention and complications, restriction and activity, medication safety, pain relief, stomach functions, further care and appointments. Both healthcare workers and patients express the need for a surgical patient safety checklist.

CONCLUSION

A broad spectre of risk elements for a patient safety checklist were identified. Developing a surgical safety checklist based on these risk elements might reduce complications and unwanted errors.

TRAIL REGISTRATION

The study is registered as part of a clinical trial in ClinicalTrials.gov: NCT03105713.

摘要

背景

在医疗保健中,患者参与患者安全的程度有所增加。使用清单可能会改善手术患者的预后,但很少有人尝试让患者使用手术清单。根据患者和医护人员的经验,确定并发症的风险因素是有必要的。本研究旨在确定患者和医护人员认为哪些风险因素应包含在患者驱动的手术患者安全清单中。

方法

采用定性研究设计,在挪威的一家三级教学医院和一家社区医院,术后患者、外科医生、病房医生、病房护士和秘书参加了焦点小组访谈。共进行了 11 个焦点小组,包括 25 名术后患者和 27 名医护人员。根据他们的经验,参与者被要求在手术前后识别出感知到的风险。使用内容分析法对访谈进行分析。

结果

安全风险因素分为术前信息:术前准备、术后信息、术后计划和随访。术前信息和准备的子类别包括:联系方式、用药安全、健康状况、优化健康、口腔状况、阅读信息、术前两周准备、通知您的外科病房、计划自己出院、入院准备和手术前准备。术后信息、进一步计划和随访的子类别包括:预防和并发症、限制和活动、用药安全、止痛、胃部功能、进一步护理和预约。医护人员和患者都表示需要一份手术患者安全清单。

结论

确定了一份患者安全清单的广泛风险因素。根据这些风险因素制定手术安全清单可能会减少并发症和不必要的错误。

试验注册

该研究作为临床试验的一部分在 ClinicalTrials.gov 注册:NCT03105713。

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