为成人医护人员创建小儿外科技能检查表。

The creation of a pediatric surgical checklist for adult providers.

机构信息

University of Illinois, Chicago, IL, USA.

Department of Surgery, Makerere University College of Health Sciences, Kampala, Uganda.

出版信息

BMC Health Serv Res. 2024 Sep 5;24(1):1029. doi: 10.1186/s12913-024-11405-1.

DOI:10.1186/s12913-024-11405-1

PMID:39232756

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11375845/

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 2023 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

Forty-two papers with 8,529,061 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

满足成人提供者对儿科手术清单的需求。

背景

儿科手术具有独特性，因为在照顾儿童时需要满足特定需求并完成许多任务。虽然有一些资源可以帮助成人外科医生进行安全的儿科手术，并帮助这些外科医生应对儿科急症，但我们还是根据现有文献创建了一个简单的清单。我们提出了一个手术清单，因为手术清单的价值已经通过在各种应用中的研究得到了验证。

方法

在 PubMed 上进行文献回顾，以收集有关儿科手术现有资源的信息，纳入截至 2023 年 10 月描述其结果的所有关于手术清单的论文，以防止对现有文献的偏见综述。对多位儿科外科医生进行了访谈，以创建一份与该领域相关且具有有限偏见的清单。

结果

共纳入 42 篇论文，总参与者为 8529061 人。文献中强调了清单在结果、财务成本和团队关系方面的积极影响。某些护理检查点被确定为重要的清单项目：抗生素给药、麻醉考虑、术中血液动力学和术后复苏。结果是创建了一个清单，它不是替代现有的世卫组织手术清单，而是为必须在紧急情况下为儿童手术的成人外科医生提供补充。