评估半结构化手术内麻醉交付认知辅助对手术患者结果的影响:一个集群随机试验的研究协议
Aubrey Samost-Williams1,2, Charles E Green3, Lillian S Kao4
1Anesthesiology, Critical Care, and Pain Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA aubrey.samostwilliams@uth.tmc.edu.
BMJ open
|November 17, 2025
概括
使用认知辅助器的结构化麻醉交付可以减少手术患者的严重30天并发症. 本试验调查了半结构化手术内麻醉交付工具对患者结果的影响.
科学领域:
- 麻醉学 麻醉学
- 患者安全 患者安全
- 医疗信息学 医疗信息学
背景情况:
- 术内麻醉的交付是关键时刻,患者信息可能会丢失,增加并发症风险.
- 建议进行结构化移交,以改善知识转移和患者护理质量.
- 在Epic电子健康记录中开发了一个半结构认知辅助器,以标准化交付.
研究的目的:
- 测试主要假设,即半结构化手术内麻醉可降低30天后严重的术后并发症.
- 评估结构化移交对轻微并发症和住院时间的影响.
主要方法:
- 一个集群随机试验,涉及大约4500名接受非心脏手术的成年患者,手术内麻醉手续.
- 半结构认知辅助器 (Epic EHR) 与常规交付器的比较.
- 主要结局:严重的30天术后并发症的数量. 二次结果:轻微的并发症和住院时间.
- 贝叶斯分析使用通用线性多层模型.
主要成果:
- 正在收集关于严重的30天并发症的初级结果数据.
- 目前正在收集关于轻微并发症和住院时间的二次结果数据.
- 分析将确定认知辅助对这些结果的影响.
结论:
- 这项研究旨在证明,通过减少并发症,结构化的手术内麻醉交接可以提高患者的安全性.
- 研究结果将为手术环境中麻醉手续的最佳实践提供信息.
- 结果将被传播,以推进患者安全和术后护理领域.
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