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手术安全核对表对不良事件发生率的影响:来自一项全国性研究的贡献。

Effect of the Surgical Safety Checklist on the incidence of adverse events: contributions from a national study.

机构信息

- Universidade Federal de Juiz de Fora, Enfermagem Aplicada - Juiz de Fora - MG - Brasil.

- Universidade Federal de Viçosa, Medicina e Enfermagem - Viçosa - MG - Brasil.

出版信息

Rev Col Bras Cir. 2022 Jun 1;49:e20223286. doi: 10.1590/0100-6991e-20223286_en. eCollection 2022.

Abstract

OBJECTIVE

the study evaluated the effect of using the safe surgery checklist (CL) on the incidence of adverse events (AE).

METHODS

cross-sectional and retrospective research with 851 patients undergoing surgical procedures in 2012 (n=428) and 2015 (n=423), representing the periods before and after CL implantation. The AE incidences for each year were estimated and compared. The association between the occurrence of AE and the presence of CL in the medical record was analyzed.

RESULTS

a reduction in the point estimate of AE was observed from 13.6% (before using the CL) to 11.8% (with the use of the CL). The difference between the proportions of AE in the periods before and after the use of CL was not significant (p=0.213). The occurrence of AE showed association with the following characteristics: anesthetic risk of the patient, length of stay, surgery time and classification of the procedure according to the potential for contamination. Considering the proportion of deaths, there was a significant reduction in deaths (p=0.007) in patients whose CL was used when compared to those without the use of the instrument. There was no significant association between the presence of CL and the occurrence of AE. It was concluded that the presence of CL in the medical record did not guarantee an expected reduction in the incidence of AE.

CONCLUSION

however, it is believed that the use of the instrument integrated with other patient safety strategies can improve the safety/quality of surgical care in the long term.

摘要

目的

本研究评估了使用安全手术检查表(CL)对不良事件(AE)发生率的影响。

方法

采用横断面和回顾性研究,纳入 2012 年(n=428)和 2015 年(n=423)行手术治疗的 851 例患者,分别代表 CL 植入前后的时间段。估计并比较每年 AE 的发生率。分析 AE 发生与病历中 CL 的存在之间的关系。

结果

AE 的点估计值从使用 CL 前的 13.6%下降至使用 CL 后的 11.8%。使用 CL 前后 AE 发生率的差异无统计学意义(p=0.213)。AE 的发生与以下特征相关:患者的麻醉风险、住院时间、手术时间和根据污染潜在可能性的手术分类。考虑到死亡率,与未使用 CL 的患者相比,使用 CL 的患者死亡率显著降低(p=0.007)。CL 的存在与 AE 的发生之间无显著相关性。结论:尽管如此,人们认为该工具的使用与其他患者安全策略相结合,可在长期内提高手术护理的安全性/质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a821/10578811/f9125fb38650/rcbc-49-e20223286-g001.jpg

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