Ameliyat öncesi cerrahi strateji toplantısı uygulamasının postoperatif sonuçlar üzerine etkisi

Öz

Amaç: İyatrojenik yaralanmalar konusunda farkındalık arttıkça, cerrahi kalite gelişimi konusunda ilgi artmaktadır. Bu yaralanmalar artan organizasyonel güvenlik kültürü ile önlenebilmektedir. Hastanemizde, ameliyat sonrası sonuçlanımları geliştirmek için klinik ve ameliyathanede cerrahi strateji toplantısı şablonu oluşturulmuştur.
Bu çalışmada ameliyat öncesi cerrahi strateji toplantosı şablonu uygulanan ve uygulanmayan hastaları karşılaştırmak için düzenlenmiştir.
Gereç ve yöntem: Hastalarn demografik verileri, ameliyat verileri ve ameliyat öncesi cerrahi strateji toplantısı verileri retrospektif olarak toplandı. Hastalar ameliyat öncesi cerrahi strateji toplantısı şablonu (PSSM) uygulama durumuna göre iki gruba ayrıldı. Grup 1’deki PSSM’si olan hastaları, grup 2 diğer hastaları içermektedir. İki gruptaki cerrahi prosedürle ilgili veriler ve hastaların sonuçları karşılaştırılmıştır.
Bulgular: Çalışmaya 140 hasta dahil edilmiştir. Hastaların ortalama yaşı 45,28±17 idi. Çalışmaya katılan hastaların kadın erkek oranı 62:78 idi. Hastalar PSSM’nin uygulanma statüsüne göre gruplandılar. Ortanca yaş (p=0,966), cinsiyet (p=1), ameliyat tipi (acil veya elektif p=0,323) ve açık cerrahiye geçme oranları (p=0.295) arasında istatistiksel olarak farklılık saptanmadı. Grup 2’de hastaların dosyalarının ameliyathanede ameliyat öncesi hazır bulunma oranı Grup 1’e oranlar istatistiksel olarka anlamlı derecede düşüktü (p=0,021). Grup 1’deki hastaların ameliyat süreleri istatistiksel olarak anlamlı derecede kısaydı (p<0,001).
Sonuç: Bu davranışsal girişimin klinikte rutin olarak uygulanması hasta sonuçlarında iyileşme, güvenlik prosedürlerin uyumu arttırmaktadır.

Anahtar Kelimeler

• Kontrol listesi
• İyatrojenik yaralanmalar
• cerrahi kalite iyileştirme
• güvenli cerrahi
• strateji toplantısı

The importance of a preoperative surgical strategy meeting for good patient outcomes

Öz

Objective: Interest in measures to surgical quality improvement is increasing with increased awareness of iatrogenic injuries. These injuries can be prevented by an improved organisational safety habit. We implemented preoperative surgical strategy meeting chart in the clinical and operational basis in our hospital to improve postoperative outcomes. This study was conducted as comparement of outcomes of patients with and without implementation of preoperative surgical strategy meeting forms. Methods: Data including the demographic characteristics of patients, procedural data, and data of preoperative surgical strategy meeting were recorded retrospectively. Patients were divided into two groups according to the preoperative surgical strategy meeting chart application status. Group 1 included the patients with provided PSSM and group 2 included the remaining patients. Data related with surgical procedure and patients’ outcomes were compared between these groups. Results: One hundred and forty patients were enrolled in this study. The mean age of the patients was 45.28±17 years. The female to male ratio was 62:78. Patients were grouped according to the application status of PSSM. There was no statistically significant difference in the mean age, sex, operation type (emergent or elective) and conversion to open surgery rates. In Group 2 being ready of patient file in the operating theatre preoperatively was statistically significantly low when compared to Group 1(p=0.021). Operation time was detected statistically significant short for patients in Group 1(p<0.001). Conclusion: Integrating this behavioural intervention into the clinical routine demonstrated the improvements in patient outcomes and adherence to the safety process.

Anahtar Kelimeler

• Checklist
• Iatrogenic injury
• quality improvement
• safe surgery
• surgical meeting

Kaynakça

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