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围手术期患者安全指标——一项德尔菲研究。

Perioperative patient safety indicators-A Delphi study.

作者信息

Nyberg Anette, Jirwe Maria, Fagerdahl Ami, Otten Volker, Haney Michael, Olofsson Birgitta

机构信息

Department of Nursing, Umeå University, Umeå, Sweden.

Department of Diagnostics and Intervention, Anaesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.

出版信息

J Clin Nurs. 2025 Apr;34(4):1351-1363. doi: 10.1111/jocn.17212. Epub 2024 May 17.

Abstract

AIM

To identify, define and achieve consensus on perioperative patient safety indicators within a Swedish context.

DESIGN

A modified Delphi method.

METHODS

A purposeful sample of 22 experts, all experienced operating room nurse specialists, was recruited for this study. A questionnaire was constructed incorporating statements derived from a preceding study. The experts were asked to rate the importance of each statement concerning patient safety during the perioperative phase. The data collection occurred through an online survey platform between November 2022 and April 2023. The CREDES checklist guided the reporting of this study.

RESULTS

The three-round Delphi study resulted in consensus on 73 statements out of 103, encompassing 74% process indicators and 26% structure indicators. Key areas of consensus included the use of the Surgical Safety Checklist and optimizing the operating room environment.

CONCLUSION

Consensus was reached on perioperative safety indicators, underscoring the intricate challenges involved in ensuring patient safety in the operating room. It emphasizes the important integration of both structure and process indicators for comprehensive safety assessment during surgical procedures. Recognizing the difficulty in measuring factors like teamwork and communication, essential for patient safety, the study offers practical guidance. It underlines a balanced approach and specific consensus areas applicable in clinical practice to enhance perioperative patient safety.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

This study provides concrete practice guidance and establishes a structured framework for evaluating perioperative care processes. It emphasizes the critical role of professionals having the necessary skills and being present during surgical procedures. Additionally, the study underscores the paramount importance of effective communication and teamwork within the operating room team, substantively contributing to overall patient safety enhancement.

IMPACT

The study focused on addressing the challenge of ensuring patient safety in operating rooms, acknowledging the persistent complications related to surgery despite global efforts to eliminate avoidable harm in healthcare. Consensus was reached on 73 crucial indicators for perioperative patient safety, emphasizing a balanced approach integrating both process and structure indicators for a comprehensive assessment of safety during surgical procedures. The study has a broad impact on professionals and healthcare systems, providing concrete guidance for practice and offering a structured process for evaluating perioperative care.

REPORTING METHOD

The study is reported informed by 'Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations derived from a methodological systematic review'.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

在瑞典背景下识别、定义围手术期患者安全指标并达成共识。

设计

改良德尔菲法。

方法

本研究招募了22名专家,均为经验丰富的手术室护士专家,采用目的抽样法。构建了一份问卷,纳入了先前一项研究中的陈述。要求专家们对围手术期患者安全相关各陈述的重要性进行评分。数据收集于2022年11月至2023年4月通过在线调查平台进行。本研究的报告遵循CREDES清单。

结果

三轮德尔菲研究在103条陈述中就73条达成了共识,其中包括74%的过程指标和26%的结构指标。达成共识的关键领域包括手术安全核对表的使用和手术室环境的优化。

结论

就围手术期安全指标达成了共识,凸显了确保手术室患者安全所涉及的复杂挑战。强调了结构指标和过程指标在手术过程中进行全面安全评估时的重要整合。认识到测量团队合作和沟通等对患者安全至关重要的因素存在困难,该研究提供了实用指导。强调了一种平衡的方法以及在临床实践中适用的具体共识领域,以提高围手术期患者安全。

对专业和患者护理的启示

本研究提供了具体的实践指导,并建立了一个评估围手术期护理过程的结构化框架。强调了专业人员具备必要技能并在手术过程中在场的关键作用。此外,该研究强调了手术室团队内部有效沟通和团队合作的至关重要性,对全面提高患者安全有实质性贡献。

影响

该研究聚焦于应对确保手术室患者安全这一挑战,承认尽管全球努力消除医疗保健中可避免的伤害,但手术相关并发症依然存在。就围手术期患者安全的73个关键指标达成了共识,强调了一种平衡的方法,将过程指标和结构指标整合起来,用于手术过程中安全的全面评估。该研究对专业人员和医疗保健系统有广泛影响,为实践提供了具体指导,并提供了一个评估围手术期护理的结构化过程。

报告方法

本研究报告遵循“姑息治疗中德尔菲研究的实施与报告指南(CREDES):方法学系统评价得出的建议”。

患者或公众贡献

无患者或公众参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80ac/11933514/a4f8b1e73c89/JOCN-34-1351-g001.jpg

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