世界卫生组织手术安全核对表是否需要针对骨科手术实践进行修改？一项针对印度骨科外科医生的横断面调查。
Does the WHO Surgical Safety Checklist Need Modification for Orthopaedic Surgery Practices? A Cross-Sectional Survey Among Indian Orthopaedic Surgeons.
作者信息
Rangasamy Karthick, Jeyaraman Madhan, Selvaraj Preethi, Gopinathan Nirmal Raj, Arumugam Divyalakshmi, Dhillon Mandeep Singh
机构信息
Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu India.
出版信息
Indian J Orthop. 2024 Jan 30;58(3):278-288. doi: 10.1007/s43465-024-01096-5. eCollection 2024 Mar.
BACKGROUND
It is well known that the implementation of the WHO surgical safety checklist (SSC) leads to improved operating room team coordination and reduced perioperative complication and mortality rates. Although it is proven to be beneficial worldwide, its awareness and usage need to be evaluated in a diverse country like India. As orthopaedic surgeries involve implants and tourniquet usage, it is important to evaluate the applicability of WHO SSC specifically to orthopaedic surgeries, and whether any modifications are needed.
MATERIALS AND METHODS
A web-based cross-sectional survey was conducted among Indian Orthopaedic Surgeons with a pre-defined questionnaire regarding awareness, usage and suggestions to modify the existing WHO SSC (2009) for orthopaedic surgeries.
RESULTS
513 responses were included for final analysis. 90.3% of surgeons were aware of the surgical safety checklist; however, only 55.8% used it routinely in their practice. The awareness of SSC availability was 1.85 times more among younger surgeons (< 20 years of experience) than among those with > 20 years of experience. 17% of surgeons thought the usage of SSC was time-consuming and 52.4% of participants felt a need to modify the existing WHO SSC (2009) for orthopaedic surgeries. 34.5% recommended the inclusion of the patient blood group in the "Sign-in" section, 62.77% proposed the inclusion of details about the tourniquet, whereas only 6.63% suggested adding about surgical implant readiness in the "Time-out" section and 72.7% suggested including a check to make sure the tourniquet was deflated, removed and also recording of the total usage time during the "Sign-out" section.
CONCLUSION
Despite high (90%) awareness among Indian Orthopaedic surgeons, they have limited usage of the WHO SSC in their practice. Identifying barriers and considering modifications for orthopaedic surgeries, like details about tourniquet usage during the "Time-out" section and a check to ensure it was removed during the "Sign-out" section, will improve patient safety and outcomes.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s43465-024-01096-5.
背景
众所周知，实施世界卫生组织手术安全核对表（SSC）可改善手术室团队协作，并降低围手术期并发症和死亡率。尽管已证明其在全球范围内有益，但在像印度这样多元化的国家，仍需对其认知度和使用情况进行评估。由于骨科手术涉及植入物和止血带的使用，因此评估世界卫生组织手术安全核对表对骨科手术的适用性以及是否需要进行任何修改非常重要。
材料与方法
针对印度骨科医生开展了一项基于网络的横断面调查，使用预先定义的问卷，内容涉及对现有世界卫生组织手术安全核对表（2009年版）用于骨科手术的认知度、使用情况及修改建议。
结果
共纳入513份回复进行最终分析。90.3%的外科医生知晓手术安全核对表；然而，只有55.8%的医生在实践中常规使用。年轻外科医生（经验不足20年）对手术安全核对表可用性的认知度比经验超过20年的外科医生高1.85倍。17%的外科医生认为使用手术安全核对表耗时，52.4%的参与者认为有必要修改现有的世界卫生组织手术安全核对表（2009年版）用于骨科手术。34.5%的人建议在“签到”部分加入患者血型，62.77%的人提议加入止血带相关细节，而只有6.63%的人建议在“暂停”部分增加手术植入物准备情况的内容，72.7%的人建议在“签出”部分加入检查以确保止血带已放气、移除，并记录总使用时间。
结论
尽管印度骨科医生的认知度较高（90%），但他们在实践中对世界卫生组织手术安全核对表的使用有限。识别障碍并考虑对骨科手术进行修改，如在“暂停”部分加入止血带使用细节以及在“签出”部分进行检查以确保其已移除，将提高患者安全和手术效果。
补充信息
在线版本包含可在10.1007/s43465-024-01096-5获取的补充材料。
Zotero 插件