摘要
目的评估国内麻醉质量与患者安全现状。方法 2016年3~4月,我们通过微信网络平台对所有新青年麻醉论坛会员发送了1份关于麻醉人员配置、术前评估、围术期麻醉监测、术后麻醉监护、麻醉不良事件上报系统、以及麻醉质量管理方面的问卷调查表。答题者可以通过手机或台式电脑来完成这份问卷调查表,每个IP地址只能容许完成问卷调查1次。结果共有8546名会员阅读了这份问卷邀请,其中3647名会员完成了问卷调查表,整体完成率占43%。72.3%的答题者报告称麻醉科人员不足。78.3%的答题者报告称他们会常规进行术前麻醉评估,69.2%的答题者会在术前常规进行气道评估,33.5%的答题者承认超过一半的术前麻醉评估是在手术室里进行的。78.9%的答题者报告称择期外科手术患者会严格遵守禁饮禁食指南。77.9%的答题者会对所有患者常规进行连续心电监护,另外99%的答题者会对所有手术患者常规进行脉搏血氧饱和度监测,而仅有55%的答题者会为全麻下的患者常规进行呼气末二氧化碳(ETCO_2)监测。30.3%的答题者所在医院的PACU会按照床位数来配备麻醉人员,43.6%的答题者所在医院的PACU会配置相应的急救设备,而37.1%的答题者所在医院没有PACU。48.4%的答题者所在科室有专门的疼痛管理团队来进行术后疼痛管理。95%的答题者相信麻醉不良事件上报系统能改善患者的安全,但是42.3%的答题者所在科室拥有麻醉不良事件上报系统且得到执行,而36.4%的答题者所在科室拥有上报系统但是却没有得到执行,仅22.6%的答题者所在科室拥有网络麻醉不良事件直报系统。2.9%的答题者表示从未执行过外科手术安全核查表,40.6%的答题者部分执行,56.5%的答题者完全执行。结论这是目前国内的第1份麻醉质控调查,这份调查反映了国内的一些潜在的麻醉安全问题。这份调查结果可以为将来的麻醉质量和患者安全改进方面的研究提供一个参考标准,也可以帮助卫生行政部门医疗政策的制定者以及医院的管理者了解目前存在的挑战,以及制定出一系列改进麻醉患者安全的对策。
Objective To evaluate status of anesthesia quality and patient safety in China. Methods A questionnaire, concerning anesthesia staffing, preoperative evaluation, perioperative anesthesia monitoring, postoperative anesthesia monitoring, anesthesia incident reporting system, and anesthesia quality administration, was delivered through New Youth Anesthesia Forum to every member from March, 2016 to April, 2016. The respondents could complete the survey via mobile device or desktop with each IP address for only one questionnaire. Results A total of 8546 members read questionnaire invitations. Of them, 3647 respondents fully completed question- naires, which represented an overall response rate of 43%. 72.3% of the respondents reported the shortage of anesthesia providers, 78.3% reported the routine preoperative anesthesia assessment, and 69.2% reported routine preoperative airway evaluation. 33.5% ofthe respondents admitted that more than half of the preoperative anesthesia assessments were performed in the operation room. Only 78.9% of the respondents reported that selective surgery patients had strictly followed NPO guideline. 77.9% of the respondents reported the routine continuous electrocardiographic; monitoring in all patients; while 99% reported the routine pulse oxygen saturation monitoring. Only 55% of the respondents reported that they routinely used end tidal carbon dioxide （ ETCO2 ） monitoring for their patients under gen- eral anesthesia. 30.3% of the respondents reported that their PACU was staffed with anesthesiologists based on the number of PACU beds, while 37.1% reported that they did not have PACU in their hospitals. 4-3.6% reported that their PACU was equipped with code carts. 48.4% of the respondents reported that they had specical pain management team for postoperative pain management. 95% of the respondents believed that anesthesia incidents reporting systems could improve the patient safety. But only 42.3% of the respondents re- ported that their departments had anesthesia incidents reporting system. 36.4% reported that they had the reporting system but without any implementation. Only 22.6% of the respondents reported that they had web-based anesthesia incidents reporting system. 2.9% of the respondents reported that they did not use the surgical safety checklists. 40.6% reported partial implementation and 56.5% reported com- plete implementation. Conclusion This is the first anesthesia quality survey in China. This survey revealed potential anesthesia safety is- sues in China. The results can serve as a benchmark for future studies about anesthesia quality and patient safety improvement in China. The evidence can help government health policy makers and hospital administers understand the challenges and develop a series of strate- gies to improve anesthesia patient safety.
出处
《麻醉安全与质控》
2017年第2期71-76,共6页
Perioperative Safety and Quality Assurance
关键词
麻醉
质量
安全
麻醉后恢复室
急性疼痛服务
anesthesia
quality
safety
post-anesthesia care unit
acute pain service
