磁共振复合手术间手术流程优化及扫描安全核查方案的应用

Optimization of the surgical process in the combined magnetic resonance imaging operation room and application of the scanning safety check plan

目的构建术中磁共振(IMRI)扫描安全核查方案,优化磁共振复合手术间手术流程,为磁共振复合手术间管理提供借鉴。方法选取2019年在郑州大学第一附属医院磁共振复合手术间进行的207台颅内占位手术,基于目视管理理论,设计"点对点"固定归位法和IMRI"四方"安全核查表对手术流程进行调整。优化后对参与扫描安全核查的手术医师、麻醉医师、巡回护士、磁共振医师进行访谈,评价流程改进效果,采用Colaizzi现象学资料7步分析法对访谈资料进行整理分析。结果对手术医师、麻醉医师、巡回护士、磁共振医师的访谈归纳为2个主题:物品定点归位可以保证IMRI安全;"四方"安全核查能保障患者安全。结论优化后的磁共振复合手术间手术流程及扫描安全核查方案能保障非兼容物品安全归位,并能提高扫描安全核查效率,提高IMRI扫描安全性。

Objective To formulate a safety check plan for intraoperative magnetic resonance imaging(IMRI),and provide a reference for the management of the combined MRI operation room.Methods Totally 207 intracranial mass lesion surgeries performed in the combined MRI operation room of the First Affiliated Hospital of Zhengzhou University in 2019 were selected.Based on the visual management theory,the"point-to-point"fixed homing method and the"four-party"safety checklist for IMRI were designed to adjust the surgical process.After optimization,the surgeons,anesthesiologists,itinerant nurses and magnetic resonance physicians who participated in the scan safety check were interviewed to evaluate the effect of process improvement.The interview data were collected and analyzed using Colaizzi's phenomenological seven-step analysis method.Results The interviews with surgeons,anesthesiologists,itinerant nurses and magnetic resonance physicians could boil down to two themes:fixed-point placement of items could ensure the safety of IMRI;"four-party"safety check could ensure patients'safety.Conclusions The optimized surgical process in the combined IMRI operation room and the scanning safety check plan can ensure the safe homing of non-compatible items,improve the efficiency of scanning safety check,and enhance the safety of IMRI.