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脊柱手术安全——促使临床医生报告运动功能方面的问题。

Safety in spinal surgery-Empowering clinicians to report concerns in motor function.

作者信息

Burrows Jennifer, Dada Eniola, Betzler Brjan, Strickland Louise, Mawhinney Gerard

机构信息

Oxford Spine Service, Oxford University Hospitals, Oxford, UK.

Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore.

出版信息

J Adv Nurs. 2025 Sep;81(9):5546-5562. doi: 10.1111/jan.16399. Epub 2024 Aug 20.

Abstract

AIMS

Timely identification of neurological deterioration in patients with spinal disorders, through spinal motor assessment, is paramount in achieving early intervention to reduce the risk of permanent deficits. This project was initiated to meet the requirement for safe, timely spinal motor assessment through establishing and addressing clinician's educational needs.

DESIGN

Mixed methods study conducted through online survey and concurrent focus groups June 2022-April 2023.

METHODS

Pre-intervention online survey and focus groups identified insufficient provision of education targeted at identifying changes in motor function and as a result, clinicians lacked confidence and competence in completing assessments and caring for patients with spinal disorders. An e-learning package was created and shared widely along with additional interventions to support assessment completion. To establish the success of the project a post-intervention online survey was distributed.

RESULTS

Survey respondents reported that the e-learning package has influenced their practice to either some extent or to a great extent with 91% reporting increased confidence in completing a spinal motor assessment. Post-intervention results also demonstrated an increase in confidence in caring for spinal surgery patients.

CONCLUSION

Through engaging with clinicians to establish and address educational needs, this quality improvement project has successfully increased competence and confidence in this area of spinal care.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study highlights the importance of targeted education to ensure that clinicians are appropriately skilled to identify neurological deterioration and demonstrates the effectiveness of digital education in providing this.

IMPACT

This study addressed concerns around timely identification of deterioration of spinal patients. Study findings were the success in utilizing digital education to increase clinician's confidence and competence and thus enhance patient safety. This research will have an impact on clinical areas caring for patients with spinal disorders.

REPORTING METHOD

SQUIRE guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

通过脊髓运动评估及时识别脊髓疾病患者的神经功能恶化,对于实现早期干预以降低永久性缺陷风险至关重要。启动该项目是为了通过确定并满足临床医生的教育需求,实现安全、及时的脊髓运动评估。

设计

2022年6月至2023年4月通过在线调查和同期焦点小组进行的混合方法研究。

方法

干预前的在线调查和焦点小组发现,针对识别运动功能变化的教育提供不足,因此临床医生在完成评估和护理脊髓疾病患者方面缺乏信心和能力。创建了一个电子学习包并广泛分享,同时采取了其他干预措施以支持评估的完成。为确定项目的成功程度,进行了干预后的在线调查。

结果

调查受访者表示,电子学习包在一定程度上或很大程度上影响了他们的实践,91%的受访者表示在完成脊髓运动评估方面信心增强。干预后的结果还表明,在护理脊髓手术患者方面的信心有所增加。

结论

通过与临床医生合作确定并满足教育需求,这个质量改进项目成功提高了脊髓护理领域的能力和信心。

对专业和/或患者护理的启示:本研究强调了针对性教育的重要性,以确保临床医生具备适当技能来识别神经功能恶化,并证明了数字教育在提供此类教育方面的有效性。

影响

本研究解决了有关及时识别脊髓患者病情恶化的问题。研究结果是成功利用数字教育提高了临床医生的信心和能力,从而增强了患者安全。这项研究将对护理脊髓疾病患者的临床领域产生影响。

报告方法

采用SQUIRE指南。

患者或公众贡献

无患者或公众参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4545/12371831/7c96a145b344/JAN-81-5546-g003.jpg

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