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Dificultad del Caso y Eventos No Rutinarios por Miembros del Equipo Quirúrgico en un Gran Estudio Observacional

Matthew B Weinger^1,2,3, Jason S Slagle^1,2,3, Jessica Feinleib⁴

¹Geriatric Research Education and Clinical Center, VA Medical Center, VA Tennessee Valley Healthcare System.

Journal of patient safety

|January 26, 2026

Resumen

La dificultad del caso del equipo quirúrgico y los eventos no rutinarios se midieron en más de 1000 procedimientos. La mayor dificultad percibida y los roles específicos se correlacionaron con un aumento de los eventos no rutinarios, lo que sugiere un vínculo con el rendimiento quirúrgico.

Área de la Ciencia:

Operaciones de Atención Médica
Seguridad Quirúrgica
Factores Humanos Médicos

Sus antecedentes:

La carga de trabajo excesiva impacta negativamente el rendimiento del operador y los resultados del paciente.
La carga de trabajo del equipo quirúrgico está mal definida, con una medición concurrente limitada en todos los roles.
La carga de trabajo del anestesiólogo, la enfermera y el cirujano durante los casos quirúrgicos sigue siendo poco estudiada.

Objetivo del estudio:

Medir las calificaciones individuales y del equipo de "dificultad del caso" entre los miembros del equipo quirúrgico.
Evaluar la ocurrencia de eventos no rutinarios (ENR) durante los procedimientos quirúrgicos.
Explorar la relación entre la dificultad percibida del caso y los ENR.

Principales métodos:

Un estudio observacional prospectivo multicéntrico que involucró 1107 cirugías no cardíacas en 5 centros médicos de VA.
Encuestas independientes recopilaron calificaciones de "dificultad del caso" (escala de 1 a 10) y ENR pre y postoperatorias de cirujanos, profesionales de anestesia y enfermeras de quirófano.
Encuestas facilitadas aseguraron la recopilación de datos independiente de todos los miembros del equipo quirúrgico.

Principales resultados:

Los eventos no rutinarios (ENR) ocurrieron en el 42,0% de los casos, y las enfermeras los informaron con mayor frecuencia (57% de los casos con ENR).
Los cirujanos calificaron consistentemente los casos como más difíciles (antes y después del caso) que los profesionales de anestesia y las enfermeras.
Tanto la calificación de la dificultad del caso por rol individual como por equipo se asociaron con la notificación de ENR.

Conclusiones:

Medir la dificultad del caso del equipo quirúrgico y los ENR es factible y ofrece información sobre los factores de rendimiento quirúrgico.
La dificultad percibida antes del caso puede servir como un predictor complementario valioso del riesgo quirúrgico.
Comprender la dinámica de la carga de trabajo del equipo es crucial para mejorar la seguridad y los resultados quirúrgicos.

Palabras clave:

evento no rutinario calidad de la atención cirugía carga de trabajo

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