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迈向围手术期患者安全的核心措施集:一项电子德尔菲共识研究。

Moving towards a core measures set for patient safety in perioperative care: An e-Delphi consensus study.

机构信息

National School of Public Health, NOVA University Lisbon, Lisbon, Portugal.

NOVA National School of Public Health, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal.

出版信息

PLoS One. 2024 Oct 23;19(10):e0311896. doi: 10.1371/journal.pone.0311896. eCollection 2024.

DOI:10.1371/journal.pone.0311896
PMID:39441853
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11498713/
Abstract

A Core Measures Set (CMS) is an agreed standardized group of measures that should be assessed and reported in research for a specific condition or clinical area. This study undertook the development of a CMS for Patient Safety through a two-round, web-based Delphi consensus approach, in the context of the "Improving quality and patient SAFEty in surgical care through STandardisation and harmonization of perioperative care in Europe" (SAFEST) project-a collaborative, patient-centered and evidence-based European Union-funded project that aims to generate action-oriented evidence in perioperative care. We developed an Initial List of Measures via an umbrella review following the deployment of an e-Delphi method with an inclusive panel of experts to prioritize measures towards a consensualized Final List of Measures. All measures were rigorously assessed for both importance and feasibility. After the two rounds of the e-Delphi consensus method we observed 13 preoperative measures (40.6% of the initial number), 24 intraoperative measures (66.7%), 25 postoperative measures (20.3%) and 23 mixed period measures (41.1%) met consensus criteria for both importance and feasibility. Higher scores were detected in importance ratings compared to feasibility across all groups of measures. Importantly, numeric averages regarding pain-related measures differed in the assessment of patients when compared to that of Healthcare Professionals (HCPs). This work not only informs future SAFEST iterations but also sets a precedent for research into valid, patient-centered, and action-oriented perioperative safety measures.

摘要

核心测量集(CMS)是一组经认可的标准化测量指标,应在特定疾病或临床领域的研究中进行评估和报告。本研究通过两轮基于网络的 Delphi 共识方法,针对“通过围手术期护理的标准化和协调来改善外科护理的质量和患者安全”(SAFEST)项目,开发了患者安全 CMS。该项目是一个合作的、以患者为中心的、基于证据的欧盟资助项目,旨在生成围手术期护理方面的面向行动的证据。我们通过伞式审查制定了一个初始措施列表,随后采用包含广泛专家的电子 Delphi 方法对措施进行优先排序,以达成共识的最终措施列表。所有措施都经过了严格的重要性和可行性评估。在两轮电子 Delphi 共识方法之后,我们观察到 13 项术前措施(初始数量的 40.6%)、24 项术中措施(66.7%)、25 项术后措施(20.3%)和 23 项混合期措施(41.1%)在重要性和可行性方面达成共识标准。与所有措施组相比,重要性评分的得分都高于可行性评分。重要的是,与医疗保健专业人员(HCP)相比,患者的疼痛相关措施评估的数值平均值存在差异。这项工作不仅为未来的 SAFEST 迭代提供了信息,也为研究有效、以患者为中心和面向行动的围手术期安全措施奠定了先例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a36/11498713/511014ff2d7d/pone.0311896.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a36/11498713/44e4bb2c6337/pone.0311896.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a36/11498713/511014ff2d7d/pone.0311896.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a36/11498713/44e4bb2c6337/pone.0311896.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a36/11498713/511014ff2d7d/pone.0311896.g002.jpg

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PLoS One. 2025 Jan 2;20(1):e0317063. doi: 10.1371/journal.pone.0317063. eCollection 2025.

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