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标准化是否能改善术后麻醉交接?关于提供者、患者、组织和交接结果的荟萃分析。

Does standardisation improve post-operative anaesthesia handoffs? Meta-analyses on provider, patient, organisational, and handoff outcomes.

机构信息

Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA.

Department of Anesthesiology, University of Minnesota Medical School, Minneapolis, MN, USA.

出版信息

Ergonomics. 2022 Aug;65(8):1138-1153. doi: 10.1080/00140139.2021.2020341. Epub 2022 Apr 19.

Abstract

Anaesthesia handoffs are associated with negative outcomes (e.g. inappropriate treatments, post-operative complications, and in-hospital mortality). To minimise these adverse outcomes, federal bodies (e.g. Joint Commission) have mandated handoff standardisation. Due to the proliferation of handoff interventions and research, there is a need to meta-analyze anaesthesia handoffs. Therefore, we performed meta-analyses on the provider, patient, organisational, and handoff outcomes related to post-operative anaesthesia handoff protocols. We meta-analysed 41 articles with post-operative anaesthesia handoffs that implemented a standardised handoff protocol. Compared to no standardisation, a standardised post-operative anaesthesia handoff changed provider outcomes with an of 4.03 (95% CI 3.20-5.08), patient outcomes with an of 1.49 (95% CI 1.32-1.69), organisational outcomes with an of 4.25 (95% CI 2.51-7.19), handoff outcomes with an of 8.52 (95% CI 7.05-10.31). Our meta-analyses demonstrate that standardised post-operative anaesthesia handoffs altered patient, provider, organisational, and handoff outcomes. We conducted meta-analyses to assess the effects of post-operative anaesthesia handoff standardisation on provider, patient, organisational, and handoff outcomes. Our findings suggest that standardised post-operative anaesthesia handoffs changed all listed outcomes in a positive direction. We discuss the implications of these findings as well as notable limitations in this literature base.

摘要

麻醉交接与负面结果相关(例如不适当的治疗、术后并发症和院内死亡率)。为了最大限度地减少这些不良后果,联邦机构(例如联合委员会)已经要求标准化交接。由于交接干预措施和研究的大量增加,因此需要对麻醉交接进行荟萃分析。因此,我们对与术后麻醉交接协议相关的提供者、患者、组织和交接结果进行了荟萃分析。我们对 41 篇实施标准化交接协议的术后麻醉交接文章进行了荟萃分析。与没有标准化相比,标准化的术后麻醉交接改变了提供者的结果, 为 4.03(95%置信区间 3.20-5.08),患者的结果为 1.49(95%置信区间 1.32-1.69),组织的结果为 4.25(95%置信区间 2.51-7.19),交接的结果为 8.52(95%置信区间 7.05-10.31)。我们的荟萃分析表明,标准化的术后麻醉交接改变了患者、提供者、组织和交接的结果。我们进行荟萃分析以评估术后麻醉交接标准化对提供者、患者、组织和交接结果的影响。我们的研究结果表明,标准化的术后麻醉交接以积极的方式改变了所有列出的结果。我们讨论了这些发现的意义以及该文献基础中的显著局限性。

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