WHO 2009手术安全核对表实施情况调查

Investigation of implementation of WHO 2009 surgical safety checklists

目的调查WHO 2009手术安全核对表实施情况。方法选取天津市儿童医院2010年5月～2011年6月手术患者100例分为A、B两组,每组各50例。应用WHO 2009手术安全核对表对A组患者进行评估,落实术前核对制度和口头报告制度。发现A组存在问题通过增改后,应用WHO 2009手术安全核对表评估B组执行情况,应用χ2检验和Fisher精确概率法比较两组执行情况。按照OTAS分类调查手术过程中人员情况,评估手术团队中各组成员的工作效率。结果 A、B两组患者在手术室停留时间基本相同,通过督促和改进手术流程,B组手术团队手术过程中在手术间停留时间明显好于A组(P<0.05)。术前核对和报告制度B组(92%)执行情况明显好于A组(56%),应用OTAS评估个人工作效率,B组(70%)的手术团队之间的交流情况明显好于A组(30%)(P<0.05)。结论围术期应用WHO 2009手术核对表有利于保护患者安全,降低手术风险,改善团队之间的工作协作。OTAS表格用于团队中人员工作情况评估,方法可行,并有助于改善团队的工作效率;术中工作模式转变有利于消除隐患,提高手术安全性。

Objective To investigate the implementation of WHO 2009 surgical safety checklists. Methods A total of 100 patients who received general surgery in Tianjin Children＇s Hospital from May 2010 to June 2011 were selected and divided into group A and group B, with 50 patients in each group. The WHO 2009 surgical safety checklist was used to evaluate the patients of group A. The preoperative patient check system and the oral reporting system were implemented to avoid errors in surgical patients and surgical sites. After the improvement based on the problems of group A, the WHO 2009 surgical safety checklist was used to evaluate the implementation situation of group B. The χ2 test and Fisher exact probability test were used to compare the implementation differences between the two groups. According to the OTAS, the personnel situation and the work efficiency of each group of the surgical team were investigated. Results The patients of group A and group B were basically the same in the operating room dwelling time, but through supervision and surgical procedure improvement, the surgical team of group B was significantly superior to that of group A in the operating room dwelling time （P 〈 0.05）. Group B （92%） was significantly better than group A （56%） in the implementation of the preoperative check and reporting systems, and group B （70%） was significantly better than group A （30%） in the communication between surgical teams （P 〈 0.05）. Conclusion The application of WHO 2009 surgical checklists in the perioperative period to initially evaluating the patient situation is conducive to protecting patient safety, reducing surgical risk, and improving coordination and cooperation between surgical teams. The application of OTAS forms to evaluating the work of surgical teams is feasible and conducive to improving the work efficiency of surgical teams. Intraoperative work mode transformation is beneficial to eliminating potential hazards and improving surgical safety.