National Institute for Health Research, Bristol, Biomedical Research Centre Surgical Innovation Theme, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.
School of Medicine, Brighton and Sussex Medical School, Brighton, UK.
BJS Open. 2024 Oct 29;8(6). doi: 10.1093/bjsopen/zrae104.
This review aimed to examine in-depth the extent and content of guidance related to the delivery of surgical procedures outside of the operating theatre.
Documents concerning the delivery of surgical procedures in non-operating theatre settings were eligible for inclusion. Guidance documents were identified from three sources: electronic databases (MEDLINE and Embase), professional organization websites and expert knowledge. No time limits were imposed. Endoscopic, interventional radiology/cardiology, dental and obstetric procedures were excluded. Eligible documents were included if specifications on the setting and descriptions of procedures were provided. Study titles, abstracts and full texts were screened for relevance. A standardized data extraction form was developed, focusing on: document type, surgical specialty, rationale for developing the guidance, setting specifications, staffing requirements, patient information and safety; descriptive statistics summarized data where appropriate. Verbatim text extracted was summarized descriptively.
Of 375 documents identified, 173 full manuscripts were reviewed and 17 were included in the scoping review, published between 1992 and 2022. Guidance provided by documents was limited. They typically included information about general procedures, setting specifications and equipment that may be required to deliver appropriate procedures in the non-operating theatre setting. There was significant heterogeneity in the terminology used to describe the non-operating theatre setting. Appropriate procedures were commonly minor procedures performed under local or topical anaesthesia. The non-theatre setting was recommended to be of adequate size for all appropriate equipment and personnel, with considerations for lighting, waste disposal, ventilation and emergency equipment. Documents also described appropriate training for staff and requirements for personal protective equipment, surgical record keeping, and occupational health and safety guidelines.
This scoping review has demonstrated there is significant heterogeneity in guidance documents concerning the delivery of surgical procedures in the non-theatre setting. Standardization of terminology and definitions is required to help inform stakeholders about the development of non-theatre setting practices.
本综述旨在深入探讨与手术室外进行外科手术相关的指导的范围和内容。
符合条件的文件包括在非手术室环境中进行手术程序的文件。指导文件是从三个来源确定的：电子数据库（MEDLINE 和 Embase）、专业组织网站和专家知识。没有时间限制。排除了内窥镜、介入放射学/心脏病学、牙科和产科手术。如果提供了手术程序的设置规范和描述，则符合条件的文件将被纳入。研究标题、摘要和全文都经过筛选，以确定其相关性。制定了标准化的数据提取表，重点关注：文件类型、手术专业、制定指导意见的理由、设置规范、人员配备要求、患者信息和安全；适当的地方采用描述性统计数据总结数据。提取的逐字文本进行了描述性总结。
在确定的 375 篇文献中，有 173 篇全文进行了审查，17 篇被纳入范围综述，发表时间为 1992 年至 2022 年。文件提供的指导有限。它们通常包括关于一般程序、设置规范和可能需要在非手术室环境中提供适当程序的设备的信息。用于描述非手术室环境的术语存在显著的异质性。适当的程序通常是在局部或局部麻醉下进行的较小程序。建议非手术室设置的大小应适合所有适当的设备和人员，并考虑照明、废物处理、通风和应急设备。文件还描述了工作人员的适当培训以及个人防护设备、手术记录保存以及职业健康和安全指南的要求。
本范围综述表明，关于在非手术室环境中进行手术程序的指导文件存在显著的异质性。需要标准化术语和定义，以帮助利益相关者了解非手术室实践的发展。
