三家印度农村医院的任务共享脊柱麻醉护理:一个非劣势随机对照临床试验
Nandakumar Menon1, Regi George2, Raman Kataria3
1ASHWINI Gudalur Adivasi Hospital, Gudalur, Tamil Nadu, India.
BMJ global health
|August 17, 2024
概括
训练有素的医务人员 (MO) 提供脊柱麻醉护理,失败率不低于咨询麻醉师 (CA). 这种任务共享的方法可以扩大印度农村的麻醉能力.
科学领域:
- 麻醉学 麻醉学
- 全球健康 全球健康
- 健康劳动力研究 卫生劳动力研究
背景情况:
- 由于劳动力短缺,医务人员 (MO) 在脊柱麻醉的任务共享在印度农村很常见.
- 为MO实施标准化的教育课程,以评估其能力.
- 该研究解决了在服务不足的地区需要可访问的麻醉护理的需求.
研究的目的:
- 评估MO的脊柱麻醉失败率是否与咨询麻醉师 (CA) 不逊.
- 评估麻醉治疗中任务共享的安全性和有效性.
- 提供证据支持在农村环境中扩大麻醉护理能力.
主要方法:
- 在印度三个农村医院进行了一项随机的非劣势试验.
- 低风险成年患者 (ASA I & II) 被随机分配到MO或CA护理.
- 机关人员接受了全面的基于任务的培训,包括模拟和直接观察.
主要成果:
- 脊柱麻醉失败率不低于:MO为3.0%,CA为2.6% (差异为0.4%).
- 两组之间没有发现术前或术后并发症的显著差异.
- 在手术期间患者报告的疼痛在MO和CA护理之间是可比的.
结论:
- 经过培训的MO可以安全有效地提供脊柱麻醉护理,实现与CA不逊色的结果.
- 通过训练有素的MO进行任务共享是一种可行的策略,可以在资源有限的农村地区加强麻醉服务的提供.
- 调查结果支持政策倡议,通过任务共享在印度扩大麻醉能力.
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