Factors compromising safety in surgery: stressful events in the operating room
Factors compromising safety in surgery: stressful events in the operating room
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DOI：
10.1016/j.amjsurg.2009.07.036
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发表时间：
2010-01-01
影响因子：
3
通讯作者：
Kneebone, Roger
中科院分区：
文献类型：
--
作者：
Arora, Sonal;Hull, Louise;Kneebone, Roger
背景：应激性事件发生在手术室(OR)，对患者安全具有潜在的严重后果。我们记录了这些事件在手术室的发生情况，评估了它们造成的压力水平，并调查了它们的可检测性。方法：观察者在55个普通和骨科手术中记录并实时评估OR中的应激事件。手术医生还对事件压力及其压力进行评分(有效的状态特质焦虑量表)。结果：每个病例的压力源总数从1到23.5(平均5.87)。技术、患者和设备问题频繁发生，压力最大。最常见但最不严重的压力源是分心/干扰，而最不频繁/最严重的压力源是团队合作问题。这些事件与外科医生自我报告的压力增加有关。观察者能够准确地捕捉外科医生的压力。结论：OR中系统发生的应激源会影响外科医生，并且可以准确地评估。进一步的研究应该调查压力对手术效果的影响。(C)2010 Elsevier Inc.保留所有权利。
BACKGROUND: Stressful events occur in the operating room (OR) with potentially severe consequences for patient safety. We recorded the incidence of these events in the OR, assessed the levels of stress that they caused, and investigated their detectability.METHODS: Stressful incidents in the OR were recorded and rated in real time by an observer in 55 general and orthopedic procedures. Operating surgeons also rated incident stressfulness and their stress (validated State Trait Anxiety Inventory).RESULTS: The total count of stressors/case ranged from 1 to 23.5 (mean, 5.87). Technical, patient, and equipment problems occurred frequently and were most stressful. Frequent but least severe stressors were distractions/interruptions, whereas least frequent/most severe stressors were teamwork problems. These events were associated with an increase in surgeons' self-reported stress. The observer was able to capture surgeons' stress accurately.CONCLUSIONS: Systematically occurring stressors in the OR affect surgeons and can be assessed accurately. Further research should investigate the impact of stress on surgical performance. (C) 2010 Elsevier Inc. All rights reserved.