發(fā)布時(shí)間：2018-05-03 03:03

  本文選題：手術(shù)及麻醉不良事件 + 手術(shù)安全核對(duì)表�。� 參考：《北京協(xié)和醫(yī)學(xué)院》2012年博士論文

【摘要】：背景：為了改善手術(shù)患者安全,有必要對(duì)手術(shù)及麻醉不良事件與手術(shù)安全核對(duì)制度的現(xiàn)狀進(jìn)行全面評(píng)估。 目的：明確我院手術(shù)及麻醉不良事件的現(xiàn)狀,尋找高效客觀的不良事件評(píng)估方法并預(yù)估手術(shù)的不良事件風(fēng)險(xiǎn)水平,評(píng)價(jià)目前手術(shù)安全核對(duì)制度的執(zhí)行情況。 方法：通過(guò)統(tǒng)一格式的病歷回顧表及問(wèn)卷調(diào)查表,對(duì)2012年2月及3月在我院基本外科、胸外科及肝臟外科住院行擇期手術(shù)的464例患者的不良事件發(fā)生情況及手術(shù)安全核對(duì)制度的執(zhí)行情況進(jìn)行全面評(píng)估。 結(jié)果：通過(guò)病歷回顧研究,共發(fā)現(xiàn)發(fā)生于98名患者(21.1%)的手術(shù)及麻醉不良事件132件(28.4件／百例手術(shù)),其中以感染發(fā)生率為最高。通過(guò)問(wèn)卷調(diào)查研究得到的不良事件發(fā)生情況與病歷回顧研究所得結(jié)果存在顯著性差異。全美醫(yī)院感染監(jiān)測(cè)(NISS)手術(shù)風(fēng)險(xiǎn)分級(jí)系統(tǒng)可以有效地預(yù)估不良事件風(fēng)險(xiǎn)水平。手術(shù)安全核對(duì)的執(zhí)行情況顯示僅27.0%手術(shù)團(tuán)隊(duì)完成了所有的核對(duì)項(xiàng)目,而僅47.3%的手術(shù)團(tuán)隊(duì)進(jìn)行了離室前核對(duì)。 結(jié)論：本研究所發(fā)現(xiàn)的手術(shù)及麻醉不良事件發(fā)生率與國(guó)外文獻(xiàn)所報(bào)道水平相比偏高。提示傳統(tǒng)的不良事件病歷回顧方法還需進(jìn)一步完善,但并發(fā)癥問(wèn)卷調(diào)查仍難以替代病歷回顧對(duì)不良事件進(jìn)行監(jiān)控。手術(shù)安全核對(duì)制度在執(zhí)行過(guò)程中尚存在諸多不規(guī)范情況。
[Abstract]:Background: in order to improve the safety of surgical patients, it is necessary to evaluate the current situation of safety check system of surgery, adverse events of anesthesia and operation. Objective: to identify the present situation of surgical and anaesthesia adverse events in our hospital, to find out an effective and objective evaluation method of adverse events, to estimate the risk level of adverse events, and to evaluate the implementation of the current safety check system. Methods: the basic surgery in our hospital in February and March 2012 was studied by using a unified medical record retrospective form and a questionnaire. The incidence of adverse events and the implementation of the safety check system were comprehensively evaluated in 464 patients with elective surgery in thoracic and liver surgery. Results: according to the retrospective study of medical records, we found that 132 adverse events of anesthesia and operation occurred in 98 patients (28.4 / 100 cases), among which the incidence of infection was the highest. There was significant difference between the adverse events and the results of retrospective study. The National Nosocomial infection Surveillance (NISS) surgical risk classification system can effectively predict the level of adverse event risk. The results of safety check showed that only 27.0% of the operation team had completed all the check items, while only 47.3% of the operation team had performed pre-room check. Conclusion: the incidence of adverse events of operation and anesthesia in this study is higher than that reported in foreign literature. It suggests that the traditional review method of adverse event medical records needs to be further improved, but the complication questionnaire is still difficult to replace the review of medical records to monitor the adverse events. There are still many irregularities in the operation safety check system.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2012
【分類號(hào)】：R612

【共引文獻(xiàn)】

相關(guān)期刊論文 前1條

1 馬爽;朱斌;黃宇光;;手術(shù)及麻醉不良事件的監(jiān)控與預(yù)防[J];協(xié)和醫(yī)學(xué)雜志;2013年04期

相關(guān)碩士學(xué)位論文 前1條

1 高淅;電針預(yù)處理對(duì)老年冠心病患者非心臟手術(shù)的心臟保護(hù)作用[D];第四軍醫(yī)大學(xué);2013年

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本文編號(hào)：1836675