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安全手术核对表:在新热带地区的评估。

Safe surgery checklist: evaluation in a neotropical region.

机构信息

- Universidade Federal de Goiás, Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina - Goiânia - GO - Brasil.

- Universidade Federal de Jataí, Curso de Enfermagem - Jataí - GO - Brasil.

出版信息

Rev Col Bras Cir. 2021 Apr 9;48:e20202710. doi: 10.1590/0100-6991e-20202710. eCollection 2021.

Abstract

OBJECTIVE

assess patient responses and associated factors of items on a safe surgery checklist, and identify use before and after protocol implementation from the records.

METHODS

a cohort study conducted from 2014 to 2016 with 397 individuals in stage I and 257 in stage II, 12 months after implementation, totaling 654 patients. Data were obtained in structured interviews. In parallel, 450 checklist assessments were performed in medical records from public health institutions in the Southwest II Health Region of Goiás state, Brazil.

RESULTS

six items from the checklist were evaluated and all of these exhibited differences (p < 0.000). Of the medical records analyzed, 69.9% contained the checklist in stage I and 96.5% in stage II, with better data completeness. In stage II, after training, the checklist was associated with surgery (OR; 1.38; IC95%: 1.25-1.51; p < 0.000), medium-sized hospital (OR; 1.11; CI95%; 1.0-1.17; p < 0.001), male gender (OR; 1.07; CI95%; 1.0-1.14; p < 0.010), type of surgery (OR; 1.7; CI95%: 1.07-1.14; p < 0.014) and antibiotic prophylaxis 30 to 60 min after incision (OR; 1.10; CI95%: 1.04-1.17; p < 0.000) and 30 to 60 min after surgery (OR; 1.23; CI95%: 1.04-1.45; p = 0.015).

CONCLUSIONS

the implementation strategy of the safe surgery checklist in small and medium-sized healthcare institutions was relevant and associated with better responses based on patient, data availability and completeness of the data.

摘要

目的

评估安全手术检查表项目的患者反应及其相关因素,并从记录中确定协议实施前后的使用情况。

方法

2014 年至 2016 年期间进行了一项队列研究,共有 397 名 I 期患者和 257 名 II 期患者,实施后 12 个月共 654 名患者。数据通过结构化访谈获得。同时,在巴西戈亚斯州西南二区公共卫生机构的医疗记录中进行了 450 次检查表评估。

结果

检查表中的 6 项均进行了评估,所有项目均存在差异(p < 0.000)。在分析的医疗记录中,I 期有 69.9%包含检查表,II 期有 96.5%,数据完整性更好。在 II 期,经过培训后,检查表与手术相关(OR;1.38;95%CI:1.25-1.51;p < 0.000),与中规模医院相关(OR;1.11;95%CI:1.0-1.17;p < 0.001),与男性性别相关(OR;1.07;95%CI:1.0-1.14;p < 0.010),与手术类型相关(OR;1.7;95%CI:1.07-1.14;p < 0.014),与手术切口后 30-60 分钟内使用抗生素预防(OR;1.10;95%CI:1.04-1.17;p < 0.000)和手术后 30-60 分钟内使用抗生素预防(OR;1.23;95%CI:1.04-1.45;p = 0.015)。

结论

在中小型医疗机构实施安全手术检查表的策略是有效的,并且与更好的反应相关,这基于患者、数据可用性和数据完整性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cba/10683426/8ce50547e597/rcbc-48-e20202710-g001.jpg

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