Analysis on omission of checking laparoscopic instruments for hepatological surgery and application evaluation of modified handing-over checking list (肝胆外科手术腹腔镜器械交接过程中漏清点事件分析与改良清点单的应用研究)

Abstract

Objective To analyze the omission events of checking laparoscopic instruments for hepatological surgery, and reduce the incidence of omission events by using modified handing-over checking list. Methods The records of handing over laparoscopic instruments for hepatological surgery from January and December 2022 were retrospectively analyzed, and a quality control team was established to optimize the handing-over checking list according to the analysis on the omission of checking laparoscopic instruments. The handing-over checking list was used in management of transferring laparoscopic instruments. The primary outcomes were incidence of omission of checking laparoscopic instruments, time costs in handing over laparoscopic instruments and medical workers’ satisfaction with checking list. Results The incidence of omission of checking laparoscopic instruments had dropped form 6. 99% to 0. 15% after using handing-over checking list. The time costs in handing over laparoscopic instruments dropped form (291. 36±43. 86) s to 113. 41±11. 50)s, with a significant difference (P<0. 05). The average score of satisfaction assessment was (24. 46±0. 85), indicating a relatively high level of satisfaction of medical workers. Conclusion The arsenal of laparoscopic instruments is vast and varied, leading to a high incidence of omission in the process of checking and handing-over. The application of handing-over checking list helps to reduce the omission rate and time costs in handing over laparoscopic instruments. (目的 统计分析肝胆外科手术腹腔镜器械交接过程中漏清点事件, 根据事件对器械清点单进行改良, 降低肝胆外科手术腹腔镜器械漏清点事件的发生。方法 回顾性分析2022年1月—12月消毒供应中心与手术室在肝胆外科手术腹腔镜器械交接过程中漏清点事件, 针对漏清点现状, 建立质量控制小组, 对器械清点单进行改良。2023年1月—12月运用改良清点单进行交接, 并从交接漏清点发生率、交接用时、应用满意度等方面分析改良清点单的应用效果。结果 应用改良清点单后, 肝胆外科手术腹腔镜器械交接漏清点发生率为0. 15%, 低于之前的6. 99%; 平均每件肝胆外科手术腹腔镜器械交接时间为(113. 41±11. 50) s, 低于应用前的(291. 36±43. 86) s, 差异有统计学意义(P＜0. 05)。改良清点单满意度评分为(24. 46±0. 85)分(满分25分), 满意度高。结论 肝胆外科手术腹腔镜器械种类多、数目多, 零部件多, 易发生漏清点事件, 应用改良清点单可显著降低漏清点发生率和交接时间, 应用方便, 值得推广应用。