Associations of flow disruptions with patient, staff, and process outcomes: a prospective observational study of robotic-assisted radical prostatectomies.
Associations of flow disruptions with patient, staff, and process outcomes: a prospective observational study of robotic-assisted radical prostatectomies.
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DOI：
10.1007/s00464-023-10162-2
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发表时间：
2023-09
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手术室（OR）的技术进步为手术工作流程、OR专业人员和患者安全带来了新的挑战。破坏性事件在所有外科专业中都很常见，但对其对患者结局的影响以及全身因素的影响知之甚少。目的是探索术中血流中断（FD）与患者结局、工作人员工作量和手术持续时间的相关性。前瞻性、单中心和多来源研究，包括泌尿外科手术、临床患者结局以及工作人员和患者报告的结局数据（PROM; 3个月随访）的直接和标准化OR观察结果。所有数据均于2020年1月至2021年10月期间记录。使用标准化程序观察评估FD。采用包括多系统因素的线性和logistic回归分析来探讨FD对手术结局的影响。捕获了61例机器人辅助根治性直肠癌切除术（61例患者和243例工作人员报告）。观察到FD的发生率较高;然而，我们的分析并未显示与患者并发症发生率的显著关系。设备和患者相关FD与工作人员工作量增加相关。较高的FD发生率与手术持续时间之间无相关性。FD与较差的患者结局无关。我们的研究结果可能会为未来的OR调查提供信息，这些调查将仔细研究人类，团队，流程和技术组件之间的复杂相互作用，以减轻手术期间FD的影响。在线版本包含补充材料，可通过10.1007/s 00464 -023-10162-2获得。
Technological advancements in the operating room (OR) have sparked new challenges for surgical workflow, OR professionals, and patient safety. Disruptive events are frequent across all surgical specialties, but little is known about their effects on patient outcomes and the influence of systemic factors. The aim was to explore the associations of intraoperative flow disruptions (FDs) with patient outcomes, staff workload, and surgery duration. Prospective, single-center, and multi-source study comprising direct and standardized OR observations of urologic surgical procedures, clinical patient outcomes, and staff- and patient-reported outcome data (PROMs; 3-month follow-up). All data were recorded between 01/2020 and 10/2021. FDs were assessed using standardized procedure observations. Linear and logistic regression analyses including multiple system factors were used to explore the effects of FDs on surgical outcomes. 61 robotic-assisted radical prostatectomy procedures were captured (with 61 patients and 243 staff reports). High rates of FDs were observed; however, our analyses did not show significant relationships with patient complication rates. Equipment- and patient-related FDs were associated with increased staff workload. No association was found between higher rates of FDs and procedure duration. FDs were not related to inferior patient outcomes. Our findings may inform future OR investigations that scrutinize the complex interplay of human, team, process, and technological components that mitigate the effects of FDs during surgery. The online version contains supplementary material available at 10.1007/s00464-023-10162-2.
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影响因子：
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