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埃塞俄比亚迪拉大学转诊医院麻醉后护理单元术后患者交接实践与安全性评估:一项横断面研究

Assessment of postoperative patient handover practice and safety at post anesthesia care unit of Dilla University Referral Hospital, Ethiopia: A cross-sectional study.

作者信息

Zemedkun Abebayehu, Destaw Belete, Hailu Seyoum, Milkias Mesay, Getachew Hailemariam, Angasa Dugo

机构信息

Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.

Department of Anesthesia, College of Health Sciences and Medicine, Hawassa University, Hawassa, Ethiopia.

出版信息

Ann Med Surg (Lond). 2022 Jun 20;79:103915. doi: 10.1016/j.amsu.2022.103915. eCollection 2022 Jul.

Abstract

INTRODUCTION

Good handover creates a common understanding of responsibility and patients' status. To proceed with effective handover process, effective communication between healthcare providers plays a vital role. But, it is commonly observed that there is ineffective communication between health care providers and it increases the risk of medical errors and negatively affects the quality of care, patient outcome and satisfaction. In addition, the transfer of care after surgery to the postanesthesia care unit (PACU) presents special challenges to providers on both the delivering and receiving teams.

METHODOLOGY

A descriptive cross-sectional study was conducted at post anesthesia care unit of Dilla University Referral Hospital from October 1 to November 30, 2020. To conduct the study, consecutively selected 208 handovers of patients from operation theatre (OT) to PACU were assessed. A checklist was developed based on a combination of criteria adopted from the Australian Medical Association 2006 and British Doctors Committee 2004. It was pilot tested and changes were made before the actual data collection.

RESULT

Our study found that the postoperative patient handover practice among professionals was poor (below 50%) in the areas of patients' full name, age, medical registration number (MRN), ASA class, allergic history, medical history, baseline vital signs, preoperative diagnosis and surgical procedure performed. Our study also found poor postoperative hand overing regarding the intraoperative blood loss 9.6%, intraoperative clinical incidents 5.3%, recovery condition 7.2%, postoperative analgesia plan 18.8%, and post operative antibiotic plan 8.2%. Whereas, type of anesthesia 81.3%, intraoperative vital signs 80.8%, and intraoperative analgesia used 79.8%, intraoperative fluid management 80.8% were among the indicators with >50% completion rate.

CONCLUSION AND RECOMMENDATION

Our study found a poor practice of patient handover regarding sociodemographic and preoperative profile, anesthesia, surgery and other necessary information. We believe standardizing this process and providing training will improve the quality of postoperative handovers and the safety of patients during this critical period.

摘要

引言

有效的交接能使医护人员对责任和患者状况达成共识。为确保交接过程有效进行,医护人员之间的有效沟通至关重要。然而,普遍观察到医护人员之间存在沟通不畅的问题,这增加了医疗差错的风险,并对护理质量、患者预后和满意度产生负面影响。此外,术后将护理工作转交给麻醉后护理单元(PACU)对交接双方的医护人员都构成了特殊挑战。

方法

2020年10月1日至11月30日,在迪拉大学转诊医院的麻醉后护理单元进行了一项描述性横断面研究。为开展该研究,连续选取了208例从手术室(OT)转至PACU的患者交接情况进行评估。基于澳大利亚医学协会2006年和英国医生委员会2004年采用的标准组合制定了一份清单。在实际数据收集之前进行了预测试并做了修改。

结果

我们的研究发现,专业人员在术后患者交接工作中,在患者全名、年龄、医疗注册号(MRN)、美国麻醉医师协会(ASA)分级、过敏史、病史、基础生命体征、术前诊断和所实施的手术等方面表现不佳(低于50%)。我们的研究还发现,在术中失血量(9.6%)、术中临床事件(5.3%)、恢复情况(7.2%)、术后镇痛计划(18.8%)和术后抗生素计划(8.2%)等方面的术后交接情况也较差。而麻醉类型(81.3%)、术中生命体征(80.8%)、术中使用的镇痛方法(79.8%)、术中液体管理(80.8%)是完成率超过50%的指标。

结论与建议

我们的研究发现,在社会人口统计学和术前资料、麻醉、手术及其他必要信息方面,患者交接工作存在不足。我们认为,规范这一过程并提供培训将提高术后交接的质量以及患者在此关键时期的安全性。

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