脊柱手术安全检查补充清单提案。

Antonio José Vargas López, Gador Ramos Bosquet, Carlos Fernández Carballal
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摘要

导言:世界卫生组织(WHO)的通用手术检查表一旦标准化并按照建议的路线执行,就需要各专科根据各自的具体程序不断改进和调整检查表:来自托雷卡德纳斯大学医院、哈恩综合医院和格雷戈里奥-马拉尼翁大学综合医院外科领域的专业人员参与了故障模式和影响分析(FMEA),通过该分析,提出了威胁脊柱外科患者安全且未列入世界卫生组织通用手术清单的问题。作者根据合适程度对提出的每个项目进行逐步评分。根据所得分数,他们选出了将纳入特定安全核对表的项目:结果:总共提出了 21 个候选项目,作为具体检查清单的一部分。这些项目的得分在 15 分至 11 分之间。经过评分,决定将评分最高的 13 个项目纳入最终的手术核对表,其中 7 个列入初始阶段,2 个列入切口前阶段,另外 4 个列入手术完成前核对表的最后部分:结论:神经外科手术领域的专业人员可以找出通用核对表中未包括的方面,这些方面如果不符合要求,对脊柱手术中患者安全的影响程度至少与世界卫生组织核对表中包括的方面相同。有可能为脊柱手术提出一个专门的补充核对表,负责收集与这些手术的安全和成功有关的方面。
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Proposal for a complementary safety checklist for spine surgery.

Introduction: Once the World Health Oraganization (WHO) generic surgical checklist has been standardized and following the itinerary proposed, it is up to the different specialties to continue advancing in the improvement and adjustment of the checklists to their specific procedures.

Methods: Through a Failure Mode and Effects Analysis (FMEA) in which professionals from the surgical area of ​​the Torrecárdenas University Hospital, Jaén Hospital Complex and Gregorio Marañón General University Hospital participated, aspects that threaten patient safety in spine surgery and that are not included in the WHO generic surgical checklist were proposed. The authors scored each of the proposed items incrementally based on the degree of suitability. Based on the score obtained, they selected those who would be incorporated into the specific safety checklist.

Results: A total of twenty-one candidate items were proposed to be part of the specific check list. These obtained scores between 15 and 11 points. After scoring them, it was decided to include the thirteen best rated in the definitive surgical checklist, seven of them in the initial phase, two in the phase prior to the incision and another four in the final part of the checklist prior to the completion of the procedure.

Conclusions: Professionals in the surgical area of ​​Neurosurgery can identify aspects not included in the generic checklist whose non-compliance can affect patient safety in spine surgery to at least the same extent as those included in WHO checklist. It is possible to propose a specific complementary checklist for spinal surgery, responsible for collecting aspects related to safety and success in these procedures.

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