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提高医护人员对手术安全检查表的依从性:短期培训的影响。

Improving Healthcare Workers' Adherence to Surgical Safety Checklist: The Impact of a Short Training.

机构信息

Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy.

Section of Occupational Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy.

出版信息

Front Public Health. 2022 Feb 8;9:732707. doi: 10.3389/fpubh.2021.732707. eCollection 2021.

Abstract

BACKGROUND

Although surgery is essential in healthcare, a significant number of patients suffer unfair harm while undergoing surgery. Many of these originate from failures in non-technical aspects, especially communication among operators. A surgical safety checklist is a simple tool that helps to reduce surgical adverse events, but even if it is fast to fill out, its compilation is often neglected by the healthcare workers because of unprepared cultural background. The present study aims to value the efficacy of a free intervention, such as a short training about risk management and safety checklist, to improve checklist adherence.

METHODS

In March 2019, the medical and nursing staff of the General Surgical Unit attended a two-lesson theoretical training concerning surgical safety and risk management tools such as the surgical safety checklist. The authors compared the completeness of the surgical checklists after and before the training, considering the same period (2 months) for both groups.

RESULT

The surgical safety checklists were present in 198 cases (70.97%) before the intervention and 231 cases (96.25%) after that. After the training, the compilation adherence increased for every different type of healthcare worker of the unit (surgeons, nurses, anesthetists, and scrab nurses). Furthermore, a longer hospitalization was associated with a higher surgical checklist adherence by the operators.

CONCLUSIONS

The results showed that a free and simple intervention, such as a two-lesson training, significantly stimulated the correct use of the surgical safety checklist. Moreover, the checklist adherence increased even for the operators who did not attend the training, maybe because of the positive influence of the colleagues' positive behaviors. As the results were promising with only two theoretical lessons, much more can be done to build a new safety culture in healthcare.

摘要

背景

尽管手术在医疗保健中至关重要,但仍有相当数量的患者在手术过程中遭受不公平的伤害。其中许多伤害源自非技术方面的失败,尤其是手术操作者之间的沟通。手术安全检查表是一种简单的工具,可以帮助减少手术不良事件,但即使填写速度很快,由于文化背景准备不足,医护人员往往会忽略其编制。本研究旨在评估一种免费干预措施(例如有关风险管理和安全检查表的短期培训)的功效,以提高检查表的依从性。

方法

2019 年 3 月,普通外科病房的医护人员参加了关于手术安全和风险管理工具(如手术安全检查表)的两课理论培训。作者比较了干预前后手术检查表的完整性,考虑到两组的相同时间段(2 个月)。

结果

干预前,手术安全检查表出现在 198 例(70.97%)病例中,干预后则出现在 231 例(96.25%)病例中。培训后,该单位的每位不同类型的医护人员(外科医生,护士,麻醉师和擦洗护士)的检查表填写依从性均有所提高。此外,住院时间延长与手术操作者更倾向于使用手术安全检查表相关。

结论

结果表明,免费且简单的干预措施(例如两课培训)可显著刺激安全检查表的正确使用。而且,即使是未参加培训的操作人员,检查表的填写依从性也有所提高,也许是因为同事的积极行为产生了积极影响。由于仅通过两课理论课程就取得了令人鼓舞的结果,因此可以在医疗保健领域中建立新的安全文化方面做得更多。

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