一项针对欧洲麻醉医师国家学会推广的围手术期质量指标的调查和分析：EQUIP 项目。
A survey and analysis of peri-operative quality indicators promoted by National Societies of Anaesthesiologists in Europe: The EQUIP project.
机构信息
From the University of Zurich, Faculty of Medicine, Zurich, Switzerland (JW), Institute of Anesthesia and Intensive Care, Hirslanden Clinic, Zurich (JW), Department of Acute Care Medicine, Division of Anesthesiology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland (GH), Department of Epidemiology and Preventive Medicine, Health Services Management and Research Unit, Monash University, Melbourne, Victoria, Australia (GH), Department of Anesthesiology, Intensive Care and Pain Therapy, OLV Hospital, Aalst (JFAH), Department of Basic and Applied Medical Sciences, Ghent University, Ghent (JFAH), Department of Anesthesiology, UZLeuven, Leuven, Belgium & Department of Cardiovascular Sciences, KULeuven, Leuven, Belgium (JFAH), Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna (MP), Department of Anesthesiology and Intensive Care, AUVA Trauma Hospital Linz, Academic Teaching Hospital of the Paracelsus Medical University, Salzburg, Austria (MP).
出版信息
Eur J Anaesthesiol. 2024 Nov 1;41(11):800-812. doi: 10.1097/EJA.0000000000002054. Epub 2024 Sep 12.
BACKGROUND
To capture preventable peri-operative patient harm and guide improvement initiatives, many quality indicators (QIs) have been developed. Several National Anaesthesiologists Societies (NAS) in Europe have implemented quality indicators. To date, the definitions, validity and dissemination of such quality indicators, and their comparability with validated published indicators are unknown.
OBJECTIVES
The aim of this study was to identify all quality indicators promoted by NAS in Europe, to assess their characteristics and to compare them with published validated quality indicators.
DESIGN
A cross-sectional study with mixed methods analysis. Using a survey questionnaire, representatives of 37 NAS were asked if their society provided quality indicators to their members and, if so, to provide the list, definitions and details of quality indicators. Characteristics of reported quality indicators were analysed.
SETTING
The 37 NAS affiliated with the European Society of Anaesthesiology and Intensive Care (ESAIC) at the time. Data collection, translations: March 2018 to February 2020.
PARTICIPANTS
Representatives of all 37 NAS completed the survey.
MAIN OUTCOME MEASURES
QIs reported by NAS.
RESULTS
Only 12 (32%) of the 37 NAS had made a set of quality indicators available to their members. Data collection was mandatory in six (16.2%) of the 37 countries. We identified 163 individual quality indicators, which were most commonly descriptive (60.1%), anaesthesia-specific (50.3%) and related to intra-operative care (21.5%). They often measured structures (41.7%) and aspects of safety (35.6%), appropriateness (20.9%) and prevention (16.6%). Patient-centred care (3.7%) was not well covered. Only 11.7% of QIs corresponded to published validated or well established quality indicator sets.
CONCLUSIONS
Few NAS in Europe promoted peri-operative quality indicators. Most of them differed from published sets of validated indicators and were often related to the structural dimension of quality. There is a need to establish a European-wide comprehensive core set of usable and validated quality indicators to monitor the quality of peri-operative care.
TRIAL REGISTRATION
No registration.
背景
为了捕捉可预防的围手术期患者伤害并指导改进措施，许多质量指标 (QI) 已经被制定。欧洲的几个国家麻醉师协会 (NAS) 已经实施了质量指标。迄今为止，这些质量指标的定义、有效性和传播，以及它们与已验证的已发表指标的可比性尚不清楚。
目的
本研究的目的是确定欧洲所有由 NAS 推广的质量指标，评估其特征，并将其与已发表的验证质量指标进行比较。
设计
混合方法分析的横断面研究。使用问卷调查，37 个 NAS 的代表被问及他们的协会是否向其成员提供质量指标，如果是，提供质量指标的清单、定义和详细信息。报告的质量指标的特征进行了分析。
设置
当时隶属于欧洲麻醉学会和重症监护学会 (ESAIC) 的 37 个 NAS。数据收集、翻译：2018 年 3 月至 2020 年 2 月。
参与者
37 个 NAS 的代表均完成了调查。
主要观察指标
NAS 报告的 QI。
结果
只有 12 个 (32%) 的 37 个 NAS 为其成员提供了一套质量指标。在 37 个国家中，有 6 个国家 (16.2%) 强制收集数据。我们确定了 163 个单独的质量指标，这些指标最常见的是描述性的 (60.1%)、专门针对麻醉的 (50.3%) 和与术中护理相关的 (21.5%)。它们经常衡量结构 (41.7%) 和安全性方面 (35.6%)、适当性 (20.9%) 和预防 (16.6%)。患者为中心的护理 (3.7%) 没有得到很好的涵盖。只有 11.7%的 QI 与已发表的验证或成熟的质量指标集相对应。
结论
欧洲只有少数 NAS 推广围手术期质量指标。他们中的大多数与已发表的验证指标集不同，并且通常与质量的结构维度有关。需要建立一个全欧洲范围的、可用的、经过验证的核心质量指标集，以监测围手术期护理的质量。
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