为成年医疗服务提供者创建的儿科手术清单。

The Creation of a Pediatric Surgical Checklist for Adult Providers.

作者信息

Rapolti Diana, Kisa Phyllis, Situma Martin, Nico Elsa, Lobe Thom, Sims Thomas, Ozgediz Doruk, Klazura Greg

机构信息

University of Illinois Hospital and Health Sciences System.

Mulago National Referral Hospital.

出版信息

Res Sq. 2023 Sep 13:rs.3.rs-3269257. doi: 10.21203/rs.3.rs-3269257/v1.

DOI:10.21203/rs.3.rs-3269257/v1

PMID:37790469

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10543282/

Abstract

PURPOSE

To address the need for a pediatric surgical checklist for adult providers.

BACKGROUND

Pediatric surgery is unique due to the specific needs and many tasks that are employed in the care of adults require accommodations for children. There are some resources for adult surgeons to perform safe pediatric surgery and to assist such surgeons in pediatric emergencies, we created a straightforward checklist based on current literature. We propose a surgical checklist as the value of surgical checklists has been validated through research in a variety of applications.

METHODS

Literature review on PubMed to gather information on current resources for pediatric surgery, all papers on surgical checklists describing their outcomes as of October 2022 were included to prevent a biased overview of the existing literature. Interviews with multiple pediatric surgeons were conducted for the creation of a checklist that is relevant to the field and has limited bias.

RESULTS

42 papers with 8529061 total participants were included. The positive impact of checklists was highlighted throughout the literature in terms of outcomes, financial cost and team relationship. Certain care checkpoints emerged as vital checklist items: antibiotic administration, anesthetic considerations, intraoperative hemodynamics and postoperative resuscitation. The result was the creation of a checklist that is not substitutive for existing WHO surgery checklists but additive for adult surgeons who must operate on children in emergencies.

CONCLUSION

The outcomes measured throughout the literature are varied and thus provide both a nuanced view of a variety of factors that must be taken into account and are limited in the amount of evidence for each outcome. We hope to implement the checklist developed to create a standard of care for pediatric surgery performed in low resource settings by adult surgeons and further evaluate its impact on emergency pediatric surgery outcomes.

FUNDING

Fulbright Fogarty Fellowship, GHES NIH FIC D43 TW010540.

摘要

目的

满足成年医疗服务提供者对儿科手术检查表的需求。

背景

儿科手术具有独特性，因为儿童护理有特定需求，许多用于成人护理的任务需要针对儿童进行调整。有一些资源可供成年外科医生进行安全的儿科手术，并在儿科急诊中协助此类外科医生，我们根据当前文献创建了一份简单的检查表。我们提出一份手术检查表，因为手术检查表的价值已在各种应用的研究中得到验证。

方法

在PubMed上进行文献综述，以收集有关当前儿科手术资源的信息，纳入截至2022年10月所有描述手术检查表结果的论文，以防止对现有文献产生有偏见的概述。对多位儿科外科医生进行访谈，以创建一份与该领域相关且偏差有限的检查表。

结果

纳入了42篇论文，共有8529061名参与者。检查表在结果、财务成本和团队关系方面的积极影响在整个文献中都得到了强调。某些护理检查点成为重要的检查表项目：抗生素给药、麻醉考虑、术中血流动力学和术后复苏。结果是创建了一份检查表，它不能替代现有的世界卫生组织手术检查表，但对于必须在紧急情况下为儿童进行手术的成年外科医生来说是一种补充。