每个手术室需要更大的麻醉医生比率,以防止不必要的非手术时间,而不是减轻患者的风险:叙述性审查
Franklin Dexter1, Richard H Epstein2, Sarah S Titler1
1University of Iowa, USA.
Journal of clinical anesthesia
|May 17, 2024
概括
优化麻醉人员配置需要更高的从业者到手术室 (OR) 比率,以确保患者的安全和OR效率. 一个比率大于1.00可以更具成本效益,提高生产率.
科学领域:
- 麻醉学 麻醉学
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医院在确定麻醉人员数量时,旨在平衡患者安全与运营效率.
- 关键目标包括在关键的手术期间确保麻醉师的存在,以及在手术室 (OR) 外的紧急情况.
- 当前的人员配置模式可能无法充分解决重叠的关键事件或非操作性任务.
研究的目的:
- 确定最佳的麻醉医生与OR比率,以减轻患者的风险并提高OR生产力.
- 审查现有的关于从业者对OR比率及其对非手术时间的影响的文献.
- 从社会角度评估不同人员配置模式的成本效益.
主要方法:
- 对来自17个不同的医院的22项研究进行了叙述性审查.
- 审查分析了导致非手术时间的活动频率,例如手术前评估和休息时间.
- 管理流行病学原则被应用来评估可通用性.
主要成果:
- 需要至少14名麻醉师来完成24小时套件,以覆盖超过90%的关键事件,这表明1.58的比率.
- 减少非手术时间所需的从业者与OR比率往往高于最初估计的.
- 每个手术室只有一名麻醉科医生,没有助理的员工,成本效益可能低于更高的比例.
结论:
- 麻醉师对OR比率超过1.00对于确保患者安全和提高OR效率至关重要.
- 术内监测的技术进步对麻醉生产率的影响有限.
- 有机会利用数据和决策支持来改善沟通和任务顺序,以减少非操作时间和提高OR效率.
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