关于脑肿瘤手术补充手术清单的建议。

Antonio José Vargas López, Gador Ramos Bosquet, Carlos Fernández Carballal
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引用次数: 0

摘要

背景和目的:一旦世界卫生组织的通用手术检查表按照建议的路线实现标准化,就需要各专科根据各自领域的程序和干预措施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-马拉尼翁大学总医院外科领域的专业人员参与了一项故障模式和影响分析(FMEA),通过这项分析,他们认识到了在脑肿瘤手术中可能影响患者安全的方面,而这些方面并不包括在世界卫生组织通用手术清单中。三位作者根据每个建议项目的合适程度,在 1 到 5 之间逐步打分。根据所得分数,他们选出了将纳入特定手术核对表的项目:结果:共有 24 个候选项目被确定纳入特定检查清单。这些项目的得分介于 14 分和 10 分之间。经过加权后,决定将评分最高的 12 个项目纳入最终的手术核对表,其中 6 个在初始阶段,3 个在切口前阶段,另外 3 个在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确定通用检查表中未包含的方面,这些方面不符合要求至少会在与通用检查表相同的程度上影响患者的安全。有可能为脑肿瘤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 surgical checklist for brain tumor surgery.

Background and objective: Once the 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 the procedures and interventions in their field.

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 could condition patient safety in the surgery of the brain tumors and that are not included in the WHO generic surgical checklist were recognized. The three authors gave a score between 1 and 5 to each of the proposed items incrementally depending on the degree of suitability. Based on the score obtained, they selected those who would be incorporated into the specific surgical checklist.

Results: A total of 24 candidate items were identified to be included in the specific check list. These obtained scores between 14 and 10 points. After this weighting, it was decided to include the 12 best-rated items in the final surgical checklist, six of them in the initial phase, three in the phase prior to the incision and another three 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 condition the patient's safety at least to the same extent as those included in the generic list. It is possible to propose a specific complementary checklist for brain tumor surgery, in charge of collecting aspects related to the safety and success of these procedures.

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