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妇科手术单元中的临床报警:回顾性数据分析。

Clinical Alarms in a Gynaecological Surgical Unit: A Retrospective Data Analysis.

机构信息

Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland.

GE Healthcare, 00510 Helsinki, Finland.

出版信息

Int J Environ Res Public Health. 2023 Feb 26;20(5):4193. doi: 10.3390/ijerph20054193.

Abstract

Alarm fatigue refers to the desensitisation of medical staff to patient monitor clinical alarms, which may lead to slower response time or total ignorance of alarms and thereby affects patient safety. The reasons behind alarm fatigue are complex; the main contributing factors include the high number of alarms and the poor positive predictive value of alarms. The study was performed in the Surgery and Anaesthesia Unit of the Women's Hospital, Helsinki, by collecting data from patient monitoring device clinical alarms and patient characteristics from surgical operations. We descriptively analysed the data and statistically analysed the differences in alarm types between weekdays and weekends, using chi-squared, for a total of eight monitors with 562 patients. The most common operational procedure was caesarean section, of which 149 were performed (15.7%). Statistically significant differences existed in alarm types and procedures between weekdays and weekends. The number of alarms produced was 11.7 per patient. In total, 4698 (71.5%) alarms were technical and 1873 (28.5%) were physiological. The most common physiological alarm type was low pulse oximetry, with a total of 437 (23.3%). Of all the alarms, the number of alarms either acknowledged or silenced was 1234 (18.8%). A notable phenomenon in the study unit was alarm fatigue. Greater customisation of patient monitors for different settings is needed to reduce the number of alarms that do not have clinical significance.

摘要

报警疲劳是指医护人员对患者监护仪临床报警的敏感性降低,这可能导致对报警的反应时间变慢或完全忽视报警,从而影响患者安全。报警疲劳的原因很复杂;主要的促成因素包括报警数量多和报警的阳性预测值差。该研究在赫尔辛基妇女医院的外科和麻醉科进行,通过从手术患者监护仪临床报警和患者特征中收集数据。我们对数据进行了描述性分析,并使用卡方检验对工作日和周末之间的报警类型差异进行了统计学分析,共分析了 8 台监护仪 562 名患者的数据。最常见的手术操作是剖宫产,共进行了 149 例(15.7%)。工作日和周末之间的报警类型和手术操作存在统计学显著差异。每位患者产生的报警数为 11.7 次。总共产生了 4698 次(71.5%)技术报警和 1873 次(28.5%)生理报警。最常见的生理报警类型是低脉搏血氧饱和度,共 437 次(23.3%)。在所有报警中,被确认或静音的报警数为 1234 次(18.8%)。在研究单位中,一个值得注意的现象是报警疲劳。需要为不同设置定制患者监护仪,以减少没有临床意义的报警数量。

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