术后患者安全建议:对临床实践指南的系统审查
Ismael Martinez-Nicolas1, Daniel Arnal-Velasco1,2, Eva Romero-García1,3
1Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR), Alcorcon, Spain.
BJS open
|December 11, 2024
概括
这项研究评估了外科手术期间的患者安全建议,发现指南质量的变化以及建议强度与证据之间的不匹配. 提高外科手术患者的安全性需要解决这些差距.
科学领域:
- 在外科手术期间的医学.
- 患者安全 患者安全
- 基于证据的实践.
背景情况:
- 手术事件是医院内不良事件的重要原因之一.
- 基于证据的实践对于改善外科手术患者安全至关重要.
- 目前缺乏一个全面的患者安全建议集.
研究的目的:
- 为成人患者编制和评估术后患者安全建议.
- 通过强有力的证据来确定高质量的建议.
- 评估现有的临床实践指南的方法严格性.
主要方法:
- 从多个数据库中对临床实践指南 (2012-2022) 的系统审查.
- 在术后护理中应用PICAR战略的资格标准.
- 使用AGREE-II工具评估指南的质量,重点关注"开发的严格性".
主要成果:
- 从267条指南中提取了4666条外科手术期间患者安全建议.
- 44.9%的建议被强烈推,其中322项具有最高的证据水平.
- 确定了78个排名最高的建议的子集,但发现了退院前和退院后护理的差距.
结论:
- 在指南的方法质量方面存在显著的变化.
- 观察到推强度和证据水平之间的不一致.
- 调查结果为政策提供信息,并促进全球外科安全的最佳实践.
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