手术安全核对表：妇科手术团队态度和障碍的定量研究。
The surgical safety checklist: a quantitative study on attitudes and barriers among gynecological surgery teams.
机构信息
Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, P. R. China.
Department of Anesthesiology, West China Second University Hospital/West China School of Medicine, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, P. R. China.
出版信息
BMC Health Serv Res. 2021 Oct 16;21(1):1106. doi: 10.1186/s12913-021-07130-8.
BACKGROUND
Implementation of the surgical safety checklist (SSC) plays a significant role in improving surgical patient safety, but levels of compliance to a SSC implementation by surgical team members vary significantly. We aimed to investigate the factors affecting satisfaction levels of gynecologists, anesthesiologists, and operating room registered nurses (OR-RNs) with SSC implementation.
METHODS
We conducted a survey based on 267 questionnaires completed by 85 gynecologists from 14 gynecological surgery teams, 86 anesthesiologists, and 96 OR-RNs at a hospital in China from March 3 to March 16, 2020. The self-reported questionnaire was used to collect respondent's demographic information, levels of satisfaction with overall implementation of the SSC and its implementation in each of the three phases of a surgery, namely sign-in, time-out, and sign-out, and reasons for not giving a satisfaction score of 10 to its implementation in all phases.
RESULTS
The subjective ratings regarding the overall implementation of the SSC between the surgical team members were different significantly. "Too many operations to check" was the primary factor causing gynecologists and anesthesiologists not to assign a score of 10 to sign-in implementation. The OR-RNs gave the lowest score to time-out implementation and 82 (85.42%) did not assign a score of 10 to it. "Surgeon is eager to start for surgery" was recognized as a major factor ranking first by OR-RNs and ranking second by anesthesiologists, and 57 (69.51%) OR-RNs chose "Too many operations to check" as the reason for not giving a score of 10 to time-out implementation. "No one initiates" and "Surgeon is not present for 'sign out'" were commonly cited as the reasons for not assigning a score of 10 to sign-out implementation.
CONCLUSION
Factors affecting satisfaction with SSC implementation were various. These factors might be essentially related to heavy workloads and lack of ability about SSC implementation. It is advisable to reduce surgical team members' excessive workloads and enhance their understanding of importance of SSC implementation, thereby improving surgical team members' satisfaction with SSC implementation and facilitating compliance of SSC completion.
背景
手术安全检查表（SSC）的实施对提高手术患者安全起着重要作用，但手术团队成员对 SSC 实施的依从程度差异很大。我们旨在调查影响妇科医生、麻醉师和手术室注册护士（OR-RN）对 SSC 实施满意度的因素。
方法
我们于 2020 年 3 月 3 日至 3 月 16 日，在中国一家医院，对来自 14 个妇科手术团队的 85 名妇科医生、86 名麻醉师和 96 名 OR-RN 进行了一项基于 267 份问卷的调查。自报问卷用于收集受访者的人口统计学信息、对 SSC 整体实施及其在手术三个阶段（签到、暂停和签出）的实施情况的满意度水平，以及对所有阶段实施均未给予 10 分满意度评分的原因。
结果
手术团队成员对 SSC 整体实施的主观评价存在显著差异。“要检查的手术太多”是导致妇科医生和麻醉师对签到实施不给予 10 分评分的主要因素。OR-RN 对暂停实施的评分最低，有 82 人（85.42%）未对其给予 10 分评分。“外科医生急于开始手术”被认为是 OR-RN 排名第一的主要因素，其次是麻醉师，有 57 名（69.51%）OR-RN 选择“要检查的手术太多”作为不给予暂停实施 10 分评分的原因。“无人发起”和“外科医生不在现场进行‘签出’”是不给予签出实施 10 分评分的常见原因。
结论
影响 SSC 实施满意度的因素多种多样。这些因素可能与工作量过大和缺乏 SSC 实施能力有关。建议减轻手术团队成员的工作量，增强他们对 SSC 实施重要性的理解，从而提高手术团队成员对 SSC 实施的满意度，促进 SSC 完成的依从性。
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