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检查点 (CheckPOINT):一个简单的工具来测量手术安全检查清单的实施忠实性
Rachel Moyal-Smith1, James C Etheridge2,3, Nathan Turley4
1Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA rsmith@ariadnelabs.org.
检查清单性能观察改善 (CheckPOINT) 工具可靠地评估世卫组织外科安全检查清单 (SSC) 的实施忠实性. 这个简单的工具捕捉了团队的坚持和团队行为,为质量改进提供了低资源的选择.
科学领域:
- 患者安全 患者安全
- 改善外科手术的质量
- 医疗保健通讯 医疗保健通讯
背景情况:
- 世卫组织的外科安全检查清单 (SSC) 对于改善团队合作和患者结果至关重要.
- 有效的SSC实施依赖于忠诚度,而行政审计和现有工具并不能完全捕捉到这一点.
- 需要一个简单,可靠的工具,用于SSC实施的常规质量保证.
研究的目的:
- 开发一个简单的工具,检查表绩效观察改进 (CheckPOINT),以评估SSC实施的忠实性.
- 使用视频模拟测试CheckPOINT工具的可靠性.
- 评估CheckPOINT工具在临床实践中的可用性.
主要方法:
- 检查点工具通过专家和临床医生进行了面部有效性测试.
- 开发了四个类别:遵守检查清单,沟通有效性,态度和参与度.
- 在由四名训练有素的评级人员进行的37次视频模拟中,使用类内相关系数 (ICC) 评估了评级者之间的可靠性. 在手术室测试了可用性.
主要成果:
- 检查点工具在SSC阶段 (ICC:登录0.83,停机0.77,退出0.79) 显示出优异的评级者间可靠性.
- 实地测试表明,该工具易于使用.
- 在98项观察中,坚持,沟通,态度和参与度的中位数得分很高,表明表现良好.
结论:
- 检查点是一个简单,可靠的工具,用于评估SSC实施的忠实性.
- 该工具有效地识别了需要改进的坚持和团队行为领域.
- 检查点为质量改善工作提供了现有研究工具的低资源替代方案.
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