国际麻醉学与复苏杂志   2019, Issue (7): 0-0
    
麻醉交接核对表对全身麻醉手术后患者交接质量的影响
沈子珒, 董榕, 杨敏, 仇健华, 袁红斌1()
1.上海交通大学医学院附属瑞金医院北院麻醉科
The effect of a general anesthesia handover checklist on the quality of post operation
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摘要:

目的 评估运用麻醉交接核对表之后是否会增加全身麻醉手术患者由手术室转运至PACU交接过程中传递的信息量。 方法 入组120例麻醉后患者,共分为3组。不宣教需要交班的所有项目且不使用麻醉交接核对表进行交班组(A组,入组40例患者);完成A组40例病例后入组80例患者,按随机数字表法分为B组和C组(每组40例):根据麻醉交接核对表要求对交班的麻醉科医师进行宣教需要交班的所有项目,交班时不使用麻醉交接核对表组(B组);根据麻醉交接核对表要求对交班的麻醉科医师进行宣教需要交班的所有项目,交班时使用麻醉交接核对表组(C组)。观察所有项目交接比例、单个项目交接比例、交接班持续时间。 结果 C组的所有项目交接比例明显高于A组和B组(P<0.05)。术中体位、ASA分级、活动耐量、过敏原、术前认知功能、与麻醉有关药物、导管放置位置、失败的穿刺、人工气道类型、液体管理、血管活性药物应用情况、呼吸机运用参数、吸氧浓度、血气参数、抗生素名称、抗生素是否需要继续使用、确认血型、确认剩余可用备血、去向(病房、PACU、ICU)、私人物品及麻醉单据项目交接比例C组明显高于A组和B组(P<0.05)。C组交接班用时明显高于A组和B组(P<0.05)。 结论 麻醉交接核对表用于麻醉后交接可以提高交接班的质量,增加交接的信息量。

关键词: 麻醉,全身; 麻醉后监测治疗室; 安全; 麻醉交接核对表
Abstract:

Objective We tested that whether a checklist for handover between anesthesiologist and post anesthesia care unit (PACU) nurse would increase the amount of information transfer during patient handover after anesthesia. Methods One hundred and twenty patients after anesthesia were divided into three groups: group A (n=40), which does not transfer and explain any items that need to be handed over and does not use the anesthesia handover checklist to carry out the transfer team. According to the method of random number table, the rest of 80 patients were divided into group B and group C (n=40). According to the requirements of the anesthetic handover checklist, all the items that needed to be handed over to the anesthesiologist were transferred and explained. But the anesthetic handover checklist group (group B) was not used when the shift was handed over. In group C, all the items that needed to be handed over to the anesthesiologist were transferred and explained by using anesthesia handover checklist when the shift was handed over. We then observed the handover ratios of all projects, the handover ratios of individual projects, and the duration of the handover. Results The handover proportion of all items in group C was significantly higher than that in group A and group B (P<0.05). Intraoperative posture, American Society of Anesthesiologists (ASA) grade, activity tolerance, dosage, allergen, preoperative cognitive function, anesthetic-related drugs and, catheter placement, failed puncture, artificial airway type, fluid management, use of vasoactive drugs, ventilator operating parameters, oxygen concentration, blood gas parameters, antibiotics name, antibiotics need to continue to use, confirm blood type, confirm the remaining available blood preparation, destination [ward, PACU, intensive care unit (ICU)], personal effects and anesthetic documents in group C was significantly higher than that in group A and group B (P<0.05). The duration of the handover in group C was significantly higher than that in group A and group B (P<0.05). Conclusions This study suggests that the use of a checklist for post-anesthesia handover might improve the quality of patient handover by increasing the information handed over.

Key words: Anesthesia, general; Post anesthesia care unit; Safety; Anesthesia handover checklist