在5个退伍军人事务医疗中心的大型前性观察研究中,手术团队成员的病例难度和非例行事件
Matthew B Weinger1,2,3, Jason S Slagle1,2,3, Jessica Feinleib4
1Geriatric Research Education and Clinical Center, VA Medical Center, VA Tennessee Valley Healthcare System.
Journal of patient safety
|January 26, 2026
概括
手术团队的病例难度和非例行事件在1000多次手术中被测量. 更高的感知难度和特定的角色与增加的非例行事件相关联,这表明与外科手术表现的联系.
科学领域:
- 医疗保健操作 医疗保健操作
- 外科手术的安全性
- 医学 人类因素 医学 人类因素
背景情况:
- 过度的工作负担会对操作人员的表现和患者的结果产生负面影响.
- 手术团队的工作量定义不佳,所有角色的同时测量有限.
- 麻醉师,护士和外科医生在外科手术中的工作负担仍未得到充分研究.
研究的目的:
- 测量手术团队成员之间的个人和团队"病例难度"评级.
- 评估在外科手术过程中发生的非例行事件 (NRE).
- 探索感知案例难度和NRE之间的关系.
主要方法:
- 一项多中心前性观察性研究,涉及5个VA医疗中心的1107次非心脏手术.
- 独立调查收集了外科医生,麻醉专业人员和OR护士的术前和术后"病例难度"评级 (1-10级) 和NREs.
- 便利调查确保了从所有外科小组成员中独立收集数据.
主要成果:
- 非常规事件 (NRE) 发生在42.0%的病例中,护士最常报告 (57%的NRE病例).
- 外科医生一致认为病例比麻醉专业人员和护士更困难 (病前和病后).
- 个人角色和团队案例难度等级都与NRE的报告相关.
结论:
- 测量手术团队的病例难度和NREs是可行的,并提供了对手术绩效因素的见解.
- 感知到的病前困难可能作为一个有价值的外科风险的补充预测指标.
- 了解团队工作负载动态对于提高手术安全性和结果至关重要.
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