Deshpande Nikita G, Witmer Hunter D D, Keceli Çağla, Adelman Dan, Turaga Kiran K
University of Chicago Pritzker School of Medicine. Biological Sciences Learning Center, 924 E. 57th Street, Suite 104, Chicago, IL, 60637, USA.
University of Chicago Medicine, Department of Surgery, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
Am J Surg. 2021 Oct;222(4):694-699. doi: 10.1016/j.amjsurg.2021.05.009. Epub 2021 May 18.
Wastage of surgical supplies results from inappropriate anticipation of surgical needs in the operating room and contributes to avoidable healthcare costs.
A retrospective, cross-sectional analysis of 28,768 elective cases at the University of Chicago Medical Center from 2016 through 2018 was conducted. Attending surgeon-scrub nurse and surgeon-circulating nurse familiarity scores were calculated. Odds of surgical waste generation based on surgeon-scrub nurse and surgeon-circulating nurse familiarity were estimated through multivariate logistic regression modeling.
Teams in the third and fourth quartiles of surgeon-scrub familiarity were significantly associated with reduced odds of waste (odds ratios 0.80 [p = 0.003] and 0.83 [p = 0.030], respectively). There was no significant reduction of odds of waste generation as surgeon-circulator familiarity increased.
Greater surgeon-scrub familiarity was associated with lower risk of waste generation. Cost savings may be realized through supporting staffing schedules that promote consistency of surgeon-scrub teams.
手术耗材的浪费是由于手术室对手术需求的预期不当造成的，这增加了可避免的医疗成本。
对2016年至2018年芝加哥大学医学中心的28768例择期手术病例进行回顾性横断面分析。计算主刀医生-洗手护士以及主刀医生-巡回护士的熟悉度得分。通过多变量逻辑回归模型估计基于主刀医生-洗手护士和主刀医生-巡回护士熟悉度产生手术耗材浪费的几率。
主刀医生与洗手护士熟悉度处于第三和第四四分位数的团队与较低的耗材浪费几率显著相关（优势比分别为0.80 [p = 0.003]和0.83 [p = 0.030]）。随着主刀医生与巡回护士熟悉度的增加，耗材浪费几率没有显著降低。
主刀医生与洗手护士之间更高的熟悉度与更低的耗材浪费风险相关。通过支持促进主刀医生-洗手护士团队一致性的人员排班计划，可以实现成本节约。
