对心胸和血管麻醉中表现不佳和受损的同事的看法,定义和准备:一项国际调查
Evangelia Samara1, Mona Momeni2, Agathi Karakosta1
1Department of Anesthesiology and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Journal of cardiothoracic and vascular anesthesia
|October 8, 2025
概括
在心胸和血管麻醉 (LPC-CTVA) 中为表现不佳的同事建立了一个共识定义. 然而,机构和临床医生在管理低绩效方面表现出有限的准备和信心,强调需要改进系统和经验.
科学领域:
- 麻醉学 麻醉学
- 医学教育 医学教育
- 医疗保健管理的管理
背景情况:
- 识别和管理低绩效的同事对于患者的安全和麻醉的专业标准至关重要.
- 目前存在的定义和机构协议,以解决心胸和血管麻醉 (CTVA) 的表现不佳问题,在全球范围内还不成熟.
- 临床医生的准备和信心在解决同事表现不佳方面有很大差异.
研究的目的:
- 在心胸和血管麻醉 (LPC-CTVA) 中为表现不佳的同事建立共识定义.
- 评估机构为识别和管理LPC-CTVA的准备情况.
- 识别与表现不佳的同事有关的识别,报告和响应行为的预测因素.
主要方法:
- 在2024年6月至9月期间,使用基于网络的问卷进行了一项国际跨部门调查.
- 一个多学科团队开发了一个由43个项目组成的问卷,评估定义,机构协议和准备.
- 分析了来自57个国家的537个完整答案的数据,以建立共识 (≥70%的同意).
主要成果:
- 在LPC-CTVA的指标上达成共识,包括不遵守感染控制,过时的知识,重复的程序失败和持续的疏忽.
- 机构支持是有限的,很少的人报告积极监督,识别机制或表现不佳的正式管理流程.
- 尽管遇到表现不佳的同事,但报告率很低,主要障碍包括责任分散,感知效率低下和对报复的恐惧. 在经验丰富的临床医生和领导者中,准备程度更高.
结论:
- 已经建立了LPC-CTVA的共识定义,为解决低绩效提供了基础.
- 机构准备和临床医生对管理表现不佳的同事的信心仍然显著有限.
- 加强准备和有效的反应能力与临床经验和结构化的机构系统的存在有关.
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