一个医学指导的学生注册护士麻醉人员模型对手术后患者结果的影响
Gen Li1, Robert E Freundlich2, Mark J Rice1
1Department of Anesthesiology, Vanderbilt University Medical Center, United States.
Journal of clinical anesthesia
|February 15, 2024
概括
这项研究发现,提供麻醉护理的注册护士麻醉师 (SRNA) 学生在医院死亡率方面与其他提供者不逊色. 然而,整体的外科结果是不确定的,因此需要进一步审查SRNA人员配置模型.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 医疗保健人员 医疗保健工作人员
背景情况:
- 学生注册护士麻醉师 (SRNA) 的资格受到争议,美国麻醉学会表示他们尚未完全有资格.
- 目前尚不清楚在医疗指导下提供麻醉护理的SRNA是否与麻醉学研究员,住院人员或认证注册护士麻醉师 (CRNA) 相比,对术后结果产生影响.
研究的目的:
- 检查医疗指导的SRNA作为室内麻醉提供者的作用是否会影响手术结果.
- 为了比较SRNA提供的麻醉护理的安全性和有效性,与其他麻醉提供者相比.
主要方法:
- 对2000年至2017年间接受住院手术的30730名成年患者进行了回顾性,匹配的队列分析.
- 倾向性得分匹配被用来比较由医疗指导的SRNA和医疗指导的CRNA,住院医生和/或研究员照顾的患者之间的结果.
- 主要综合结局包括住院死亡率和六种主要疾病类别;住院死亡率是次要结局.
主要成果:
- 主要综合结局发生在医疗指导的SRNA和其他提供者的7.5%的病例中,使非劣势性不确定的 (RR,1.02;95% CI,0.94-1.11;P = .07).
- 然而,医疗指导的SRNA组在住院死亡率方面表现出非劣势 (0.8%对1.0%;RR,0.75;95%CI,0.59-0.96;P <.001).
结论:
- 与其他麻醉专业人员相比,医疗指导的SRNA作为单独的室内麻醉提供者对于整体手术结果的非劣等性,结果不确切.
- 该研究表明,在这种人员配置模式下使用医疗指导的SRNA需要进一步调查.
- 虽然总体结果是不确定的,但SRNAs被发现对住院死亡率不逊色.
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