从手术飞行计划开始改善术前沟通和及时发现第一例病例:一项试点研究

Reuben A. Falola, N. Rodriguez-Unda, R. Probe, H. Papaconstantinou, M. Saint-Cyr, Andrew M. Altman
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引用次数: 0

摘要

背景 闭环沟通对于管理多样化的手术团队至关重要。当新成员或不熟悉的成员在场时,就像轮班围手术期护理中常见的那样,有效沟通可能会遇到挑战。方法 我们在我们的三级学术中心推出了手术飞行计划(SFP),这是一种新颖的沟通工具,可以在手术前向手术团队成员告知手术细节。该工具在手术前已在电子健康记录中提供。应用SFP后评估的主要结果是“患者在手术室到切口的时间”。次要结果是通过标准化(10项)干预前调查和3个月后的随访干预后调查评估的“手术团队沟通的改善”。使用Redcap软件收集数据,并使用SAS 9.4进行统计分析,显著性设置为p值小于0.05。结果 36例首次开始手术的整形外科病例被纳入分析(干预前20例,干预后16例)。从病人住院到手术结束的平均时间分别为59.15和48.69 干预前/干预后的分钟数(p < .0437)。61名外科团队成员对调查做出了回应,大多数人表示团队沟通有所改善。结论 SFP显著改善了首次病例准时开始(FCOTS),并可能改善手术团队的沟通、效率、安全性和整体患者护理。需要将该仪器的使用范围扩大到其他外科专业,以进一步验证其疗效。
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Improving Preoperative Communication and First Case On-Time Starts with the Surgical Flight Plan: A Pilot Study
Background Closed-loop communication is essential for managing a diverse surgical team. When new or unfamiliar members are present, as is common in shift-based perioperative care, challenges to effective communication can arise. Methods We introduced the Surgical Flight Plan (SFP), a novel communication tool that informs surgical team members on procedural details in advance of surgery, at our tertiary academic center. The tool was made available in the electronic health record prior to surgery. The primary outcome assessed after application of the SFP was “patient-in-room to incision time.” The secondary outcome was “improvement of communication in surgical teams” as assessed by a standardized (10-item) preintervention survey and a follow-up postintervention survey, given 3 months later. Data were gathered using Redcap software and statistical analysis was performed using SAS 9.4, significance was set at p-value less than 0.05 Results Thirty-six first-start, operative plastic surgery cases were included for the analysis (20 pre- and 16 postintervention). The average time from patient-in-room to surgical time out were 59.15 and 48.69 minutes pre-/postintervention respectively (p < .0437). Sixty-one members of the surgical team responded to the survey, with the majority citing improved team communication. Conclusion The SFP significantly improved first case on-time starts (FCOTS) and may improve surgical team communication, efficiency, safety, and overall patient care. Expanding the use of the instrument into other surgical specialties is needed to further validate its efficacy.
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