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Возможности уменьшения хирургических осложнений при применении протокола безопасности хирургического вмешательства
Возможности уменьшения хирургических осложнений при применении протокола безопасности хирургического вмешательства
Кондратова Н.В. Возможности уменьшения хирургических осложнений при применении протокола безопасности хирургического вмешательства. Consilium Medicum. Хирургия (Прил.). 2015; 2: 25–27.
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Аннотация
Цель: внедрить в практику многопрофильного хирургического стационара протокол безопасности хирургического вмешательства согласно требованиям международных стандартов качества и оценить динамику количества послеоперационных осложнений в течение 2 лет после внедрения протокола.
Материалы и методы: исследование выполнено в 2012–2014 гг. на базе многопрофильного хирургического стационара клиники ОАО «Медицина», проведена оценка динамики количества послеоперационных осложнений при выполнении 4249 хирургических операций.
Результаты: после внедрения протокола безопасности хирургического вмешательства количество послеоперационных осложнений достоверно уменьшилось с 0,73 до 0,1% в течение 2 лет.
Заключение: внедрение протокола безопасности хирургического вмешательства является эффективным инструментом управления рисками и повышения безопасности пациента.
Ключевые слова: протокол безопасности хирургического вмешательства, требования международных стандартов качества, послеоперационные осложнения, управление рисками.
Materials and methods: research was done in 2012–2014 in multi-profile surgical hospital of “Medicine” clinic, dynamic of surgical complications number was assessed after 4249 surgeries.
Results: after implementation of safe surgery protocol the number of surgical complication has been significantly decreased from 0,73 to 0,1% in 2 years period.
Conclusion: implementation of safe surgery protocol is an effective instrument of risk management and patient safety improvement.
Key words: safe surgery protocol, international quality standards requirements, surgical complications, risk management.
Материалы и методы: исследование выполнено в 2012–2014 гг. на базе многопрофильного хирургического стационара клиники ОАО «Медицина», проведена оценка динамики количества послеоперационных осложнений при выполнении 4249 хирургических операций.
Результаты: после внедрения протокола безопасности хирургического вмешательства количество послеоперационных осложнений достоверно уменьшилось с 0,73 до 0,1% в течение 2 лет.
Заключение: внедрение протокола безопасности хирургического вмешательства является эффективным инструментом управления рисками и повышения безопасности пациента.
Ключевые слова: протокол безопасности хирургического вмешательства, требования международных стандартов качества, послеоперационные осложнения, управление рисками.
________________________________________________
Materials and methods: research was done in 2012–2014 in multi-profile surgical hospital of “Medicine” clinic, dynamic of surgical complications number was assessed after 4249 surgeries.
Results: after implementation of safe surgery protocol the number of surgical complication has been significantly decreased from 0,73 to 0,1% in 2 years period.
Conclusion: implementation of safe surgery protocol is an effective instrument of risk management and patient safety improvement.
Key words: safe surgery protocol, international quality standards requirements, surgical complications, risk management.
Полный текст
Список литературы
1. World Health Organization World Alliance For Patient Safety – Safe Surgery Saves Lives Geneva: WHO; 2008. http://www.who.int/patientsafety/safesurgery/knowledge_base/SSSL_Brochure_finalJun08.pdf
2. Gawande AA et al. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 1999; 126: 66–75.
3. Kable AK, Gibberd RW, Spigelman AD. Adverse events in surgical patients in Australia. Int J Quality in Health Care 2002; 14: 269–76.
4. Weiser TG, Regenbogen SE, Thompson KD et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 2008; 372: 139–44.
5. Cooper JB et al. Preventable anesthesia mishaps: a study of human factors. Anesthesiology 1978; 49: 399–406.
6. Joint Commission. Universal protocol for preventing wrong site, wrong procedure, wrong person surgery. 2003. ıhttp://www.jointcommission.org/ PatientSafety/UniversalProtocol
7. Международные стандарты аккредитации медицинских организаций. Пер. с англ. Под ред. А.Ю.Абрамова, Г.Э.Улумбековой. М., 2013. / Mezhdunarodnye standarty akkreditatsii meditsinskikh organizatsii. Per. s angl. Pod red. A.Iu.Abramova, G.E.Ulumbekovoi. M., 2013. [in Russian]
8. Makary MA et al. Operating room briefings: working on the same page. Jt Comm J Qual Patient Saf 2006; 32: 351–5.
9. Altpeter T et al. Expanded surgical time out: a key to real-time data collection and quality improvement. J Am Coll Surg 2007; 204: 527–32.
10. Panesar SS, Noble DJ, Mirza SB et al. Can the surgical checklist reduce the risk of wrong site surgery in orthopaedics? Can the checklist help? Supporting evidence from analysis of a national patient incident reporting system. J Orthop Surg Res 2011; 6.
11. Truran P, Critchley RJ, Gilliam A. Does using the WHO surgical checklist improve compliance to venous thromboembolism prophylaxis guidelines? Surgeon 2011; 9: 309–11.
12. Pronovost P et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725–32.
13. Weiser TG, Haynes AB, Dziekan G et al. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010; 251: 976–80.
14. Hacquard P, Cunat C, Toussaint C et al. Assessment of the check-list in the operating room: perceptions of caregivers and physicians (level II assessment) Ann Fr Anesth Reanim 2013; 32 (4): 235–40.
15. Hales BM, Pronovost PJ. The checklist – a tool for error management and performance improvement. J Crit Care 2006; 21: 231–5.
2. Gawande AA et al. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 1999; 126: 66–75.
3. Kable AK, Gibberd RW, Spigelman AD. Adverse events in surgical patients in Australia. Int J Quality in Health Care 2002; 14: 269–76.
4. Weiser TG, Regenbogen SE, Thompson KD et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 2008; 372: 139–44.
5. Cooper JB et al. Preventable anesthesia mishaps: a study of human factors. Anesthesiology 1978; 49: 399–406.
6. Joint Commission. Universal protocol for preventing wrong site, wrong procedure, wrong person surgery. 2003. ıhttp://www.jointcommission.org/ PatientSafety/UniversalProtocol
7. Mezhdunarodnye standarty akkreditatsii meditsinskikh organizatsii. Per. s angl. Pod red. A.Iu.Abramova, G.E.Ulumbekovoi. M., 2013. [in Russian]
8. Makary MA et al. Operating room briefings: working on the same page. Jt Comm J Qual Patient Saf 2006; 32: 351–5.
9. Altpeter T et al. Expanded surgical time out: a key to real-time data collection and quality improvement. J Am Coll Surg 2007; 204: 527–32.
10. Panesar SS, Noble DJ, Mirza SB et al. Can the surgical checklist reduce the risk of wrong site surgery in orthopaedics? Can the checklist help? Supporting evidence from analysis of a national patient incident reporting system. J Orthop Surg Res 2011; 6.
11. Truran P, Critchley RJ, Gilliam A. Does using the WHO surgical checklist improve compliance to venous thromboembolism prophylaxis guidelines? Surgeon 2011; 9: 309–11.
12. Pronovost P et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725–32.
13. Weiser TG, Haynes AB, Dziekan G et al. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010; 251: 976–80.
14. Hacquard P, Cunat C, Toussaint C et al. Assessment of the check-list in the operating room: perceptions of caregivers and physicians (level II assessment) Ann Fr Anesth Reanim 2013; 32 (4): 235–40.
15. Hales BM, Pronovost PJ. The checklist – a tool for error management and performance improvement. J Crit Care 2006; 21: 231–5.
2. Gawande AA et al. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 1999; 126: 66–75.
3. Kable AK, Gibberd RW, Spigelman AD. Adverse events in surgical patients in Australia. Int J Quality in Health Care 2002; 14: 269–76.
4. Weiser TG, Regenbogen SE, Thompson KD et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 2008; 372: 139–44.
5. Cooper JB et al. Preventable anesthesia mishaps: a study of human factors. Anesthesiology 1978; 49: 399–406.
6. Joint Commission. Universal protocol for preventing wrong site, wrong procedure, wrong person surgery. 2003. ıhttp://www.jointcommission.org/ PatientSafety/UniversalProtocol
7. Международные стандарты аккредитации медицинских организаций. Пер. с англ. Под ред. А.Ю.Абрамова, Г.Э.Улумбековой. М., 2013. / Mezhdunarodnye standarty akkreditatsii meditsinskikh organizatsii. Per. s angl. Pod red. A.Iu.Abramova, G.E.Ulumbekovoi. M., 2013. [in Russian]
8. Makary MA et al. Operating room briefings: working on the same page. Jt Comm J Qual Patient Saf 2006; 32: 351–5.
9. Altpeter T et al. Expanded surgical time out: a key to real-time data collection and quality improvement. J Am Coll Surg 2007; 204: 527–32.
10. Panesar SS, Noble DJ, Mirza SB et al. Can the surgical checklist reduce the risk of wrong site surgery in orthopaedics? Can the checklist help? Supporting evidence from analysis of a national patient incident reporting system. J Orthop Surg Res 2011; 6.
11. Truran P, Critchley RJ, Gilliam A. Does using the WHO surgical checklist improve compliance to venous thromboembolism prophylaxis guidelines? Surgeon 2011; 9: 309–11.
12. Pronovost P et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725–32.
13. Weiser TG, Haynes AB, Dziekan G et al. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010; 251: 976–80.
14. Hacquard P, Cunat C, Toussaint C et al. Assessment of the check-list in the operating room: perceptions of caregivers and physicians (level II assessment) Ann Fr Anesth Reanim 2013; 32 (4): 235–40.
15. Hales BM, Pronovost PJ. The checklist – a tool for error management and performance improvement. J Crit Care 2006; 21: 231–5.
________________________________________________
2. Gawande AA et al. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 1999; 126: 66–75.
3. Kable AK, Gibberd RW, Spigelman AD. Adverse events in surgical patients in Australia. Int J Quality in Health Care 2002; 14: 269–76.
4. Weiser TG, Regenbogen SE, Thompson KD et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 2008; 372: 139–44.
5. Cooper JB et al. Preventable anesthesia mishaps: a study of human factors. Anesthesiology 1978; 49: 399–406.
6. Joint Commission. Universal protocol for preventing wrong site, wrong procedure, wrong person surgery. 2003. ıhttp://www.jointcommission.org/ PatientSafety/UniversalProtocol
7. Mezhdunarodnye standarty akkreditatsii meditsinskikh organizatsii. Per. s angl. Pod red. A.Iu.Abramova, G.E.Ulumbekovoi. M., 2013. [in Russian]
8. Makary MA et al. Operating room briefings: working on the same page. Jt Comm J Qual Patient Saf 2006; 32: 351–5.
9. Altpeter T et al. Expanded surgical time out: a key to real-time data collection and quality improvement. J Am Coll Surg 2007; 204: 527–32.
10. Panesar SS, Noble DJ, Mirza SB et al. Can the surgical checklist reduce the risk of wrong site surgery in orthopaedics? Can the checklist help? Supporting evidence from analysis of a national patient incident reporting system. J Orthop Surg Res 2011; 6.
11. Truran P, Critchley RJ, Gilliam A. Does using the WHO surgical checklist improve compliance to venous thromboembolism prophylaxis guidelines? Surgeon 2011; 9: 309–11.
12. Pronovost P et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725–32.
13. Weiser TG, Haynes AB, Dziekan G et al. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010; 251: 976–80.
14. Hacquard P, Cunat C, Toussaint C et al. Assessment of the check-list in the operating room: perceptions of caregivers and physicians (level II assessment) Ann Fr Anesth Reanim 2013; 32 (4): 235–40.
15. Hales BM, Pronovost PJ. The checklist – a tool for error management and performance improvement. J Crit Care 2006; 21: 231–5.
Авторы
Н.В.Кондратова*
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
Клиника ОАО «Медицина». 125047, Россия, Москва, 2-й Тверской-Ямской пер., д. 10
*kondratova@medicina.ru
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
Medicine clinic. 125047, Russian Federation, Moscow, 2-i Tverskoi-Iamskoi per., d. 10
*kondratova@medicina.ru
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
Клиника ОАО «Медицина». 125047, Россия, Москва, 2-й Тверской-Ямской пер., д. 10
*kondratova@medicina.ru
________________________________________________
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
Medicine clinic. 125047, Russian Federation, Moscow, 2-i Tverskoi-Iamskoi per., d. 10
*kondratova@medicina.ru
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