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[内脏外科跨专业培训病房的患者护理安全]

[Safety of patient care on an interprofessional training ward in visceral surgery].

作者信息

Hellinger A, Hörscher D, Biber F C, Haasenritter J, Jost K, Kreuzer T, Müller H-H, Wächtershäuser E M, Weber J, Weise C, Opitz E

机构信息

Klinik für Allgemein‑, Viszeral‑, Endokrine und Onkologische Chirurgie, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Pacelliallee 4, 36043, Fulda, Deutschland.

Institut für Allgemeinmedizin, Philipps-Universität Marburg, Marburg, Deutschland.

出版信息

Chirurgie (Heidelb). 2024 Apr;95(4):299-306. doi: 10.1007/s00104-024-02034-9. Epub 2024 Feb 6.

Abstract

BACKGROUND

Interprofessional training wards (ITW) are increasingly being integrated into teaching and training concepts in visceral surgery clinics.

OBJECTIVE

How safe is patient care on an ITW in visceral surgery?

MATERIAL AND METHODS

Data collection took place from November 2021 to December 2022. In this nonrandomized prospective evaluation study the frequency and severity of adverse events (AE) in 3 groups of 100 patients each in a tertiary referral center hospital for visceral surgery were investigated. The groups consisted of patients on the ITW and on the conventional ward before and after implementation of the ITW. The Global Trigger Tool (GTT) was used to search for AE. Simultaneously, a survey of the treatment was conducted according to the Picker method to measure patient reported outcome.

RESULTS

Baseline characteristics and clinical outcome parameters of the patients in the three groups were comparable. The GTT analysis found 74 nonpreventable and 5 preventable AE in 63 (21%) of the patients and 12 AE occurred before the hospital stay. During the hospital stay 50 AE occurred in the operating theater and 17 on the conventional ward. None of the five preventable AE (in 1.7% of the patients) was caused by the treatment on the ITW. Patients rated the safety on the ITW better than in 90% of the hospitals included in the Picker benchmark cohort and as good as on the normal ward.

CONCLUSION

The GTT-based data as well as from the patients' point of view show that patient care on a carefully implemented ITW in visceral surgery is safe.

摘要

背景

跨专业培训病房(ITW)越来越多地被纳入内脏外科诊所的教学和培训理念中。

目的

在内脏外科的ITW上,患者护理的安全性如何?

材料与方法

数据收集于2021年11月至2022年12月进行。在这项非随机前瞻性评估研究中,调查了一家三级转诊中心医院内脏外科每组100名患者共3组中的不良事件(AE)的频率和严重程度。这些组包括ITW上的患者以及ITW实施前后常规病房的患者。使用全球触发工具(GTT)来搜索AE。同时,根据Picker方法对治疗进行了调查,以测量患者报告的结果。

结果

三组患者的基线特征和临床结局参数具有可比性。GTT分析在63名(21%)患者中发现了74起不可预防的AE和5起可预防的AE,并且在住院前发生了12起AE。住院期间,手术室发生了50起AE,常规病房发生了17起。五起可预防的AE(占患者的1.7%)均不是由ITW上的治疗引起的。患者对ITW安全性的评价优于Picker基准队列中90%的医院,与普通病房一样好。

结论

基于GTT的数据以及从患者角度来看,在内脏外科精心实施的ITW上的患者护理是安全的。

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