Okeke Chike John, Okorie Chukwudi Ogonnaya, Ojewola Rufus Wale, Omoke Njoku Isaac, Obi Anselm Okwudili, Egwu Agama Nnachi, Onyebum Okechukwu Valentine
Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
Department of Surgery, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos, Nigeria.
Niger J Surg. 2020 Jul-Dec;26(2):110-116. doi: 10.4103/njs.NJS_61_19. Epub 2020 Jul 27.
Operating room delay has multiple negative effects on the patients, surgical team, and the hospital system. Maximum utilization of the operating room requires on-time knife on the skin and efficient turnover. Knowledge of the reasons for the delay will form a basis toward proffering solutions.
This was a prospective study of all consecutive elective cases done over a 15-month period from January 2016 to March 2017. Using our departmental protocol that "knife on skin" for the first elective case should be 8.00am, the delay was defined as a surgery starting later than 8.00am for the first cases while the interval between the cases of >30 min for the knife on the skin was used for subsequent cases. Reasons for delay in all cases of delay were documented. The prevalence and causes of the delays were analyzed. < 0.05 was considered statistically significant.
Of 1178 surgeries performed during the period of study, 1170 (99.3%) of cases were delayed. The mean delay time was 151 min for all cases. First on the list had a longer delay time than others; 198.9 min versus 108.5 min ( = 0.000). Delay in the first cases accounted for 47.5% of all delayed cases. Overall, patient-related factor was the most common cause of delay (31.3%) followed in descending order by surgeon-related factor (28.5%) and hospital-related factor (26.2%). Patient-related factors accounted for 43.2% of first-case delays.
Delays encountered in this study were multifactorial and are preventable. Efforts should be directed at these different causes of delay in the theater to mitigate these delays and improve productivity.
手术室延迟对患者、手术团队和医院系统有多种负面影响。手术室的最大利用率要求准时开刀并实现高效周转。了解延迟原因将为提出解决方案奠定基础。
这是一项对2016年1月至2017年3月期间连续进行的所有择期手术病例的前瞻性研究。根据我们科室的规定，第一例择期手术的“开刀时间”应为上午8点，延迟定义为第一例手术开始时间晚于上午8点，而后续病例的开刀间隔时间大于30分钟。记录所有延迟病例的延迟原因。分析延迟的发生率和原因。P < 0.05被认为具有统计学意义。
在研究期间进行的1178例手术中，1170例（99.3%）出现延迟。所有病例的平均延迟时间为151分钟。排在首位的病例延迟时间比其他病例更长；分别为198.9分钟和108.5分钟（P = 0.000）。第一例病例的延迟占所有延迟病例的47.5%。总体而言，与患者相关的因素是最常见的延迟原因（31.3%），其次按降序排列为与外科医生相关的因素（28.5%）和与医院相关的因素（26.2%）。与患者相关的因素占第一例病例延迟的43.2%。
本研究中遇到的延迟是多因素的且可预防。应针对手术室中这些不同的延迟原因采取措施，以减轻这些延迟并提高工作效率。
