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我们是如何真正的世卫组织:评估完整性,团队参与,分心和权威梯度在"休息时间"组成部分的世卫组织更安全的手术检查清单期间
Wai Yoong1, Suzanne Reilly1, Hashviniya Sekar1
1Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK.
The Australian & New Zealand journal of obstetrics & gynaecology
|December 31, 2024
概括
世卫组织更安全的手术检查清单的"休息时间"通常不完全实施,分心和团队参与度低影响其在产科和妇科方面的有效性. 提高意识是提高外科安全的关键.
科学领域:
- 医疗安全 医疗安全
- 手术手术手术手术手术手术手术手术手术手术
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 世界卫生组织 (WHO) 的安全外科手术检查清单旨在提高患者的安全.
- 事证据表明,检查清单,特别是"休息时间"部分,可能被视为程序形式,而不是积极参与的工具.
- 报告说,团队参与和有效性是可变的,这可能会破坏检查清单的预期好处.
研究的目的:
- 评估世卫组织安全外科手术检查清单"休息"阶段的质量和完整性.
- 评估在产科和妇科外科手术过程中的团队参与程度.
- 确定影响团队沟通和参与"休息时间"的因素,如分心和权威梯度.
主要方法:
- 在70个产科和妇科病例中进行了一项观察性研究.
- 收集的数据包括正确处理的"休息时间"项目的百分比,分心的类型和持续时间,以及团队参与程度.
- 视觉模拟量表被用来评估权威梯度和团队成员发言的可能性.
主要成果:
- 在91.4%的案例中宣布了"休息时间",并在所有情况下进行,但并不总是以正确的"挑战和响应"格式进行.
- 平均92%的"停机"项目被适当地挑战和响应,平均持续时间为92秒.
- 发现了大量的分心 (听觉,视觉,聊天,交通),在92.8%的案例中,至少有两名团队成员被解散,执行非必要的任务. 发言的可能性很高 (8.78/10) 并且独立于角色.
结论:
- 尽管执行了"时机"程序,但经常没有明确宣布或使用预期的"挑战和响应"方法完成.
- "休息时间"往往受到可避免的分心和低于最佳的团队参与的影响,从而降低了其潜在的有效性.
- 提高意识和遵守适当的"休息"协议对于确保团队全面参与和最大限度地提高外科安全至关重要.
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