择期手术当日手术取消原因分析及对策  

Analysis of the causes of surgical cancellations on the day of elective surgery and measures for improvement

作　　者：刘飞飞[1] 赵爽[1] 吴川[1] 王秀丽[1] LIU Feifei;ZHAO Shuang;WU Chuan;WANG Xiuli(Department of Anesthesiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院麻醉科,河北石家庄050051

出　　处：《麻醉安全与质控》2018年第3期153-156,共4页Perioperative Safety and Quality Assurance

基　　金：河北省医学适用技术跟踪项目(GL2016-29)

摘　　要：目的了解择期手术当日取消手术情况并分析原因,并对麻醉科采取对策的效果进行评价。方法对2016年择期手术当日取消手术的病例进行回顾性分析,计算不同年龄患者的手术取消率并分析取消手术的具体原因,麻醉科针对原因采取对策。比较2017年与2016年择期手术非计划取消率的变化,并对麻醉科采取措施的效果进行评价。结果 2016年择期手术取消原因主要包括术者自停3.8%、术前检查不全2.0%、患者术前准备不充分1.6%。其中儿童组12.1%,中青年组8.2%,老年组10.3%。麻醉科通过与手术医生和患者有效沟通、完善患者术前准备、加强学习理论知识降低了择期手术取消率,从2016年的9.1%下降到2017年的7.9%。中青年组择期手术取消率下降差异有统计学意义。从原因分析,术者自停和检查不全取消手术2017年较2016年明显下降,差异有统计学意义。结论医护人员应加强术前评估和准备,重视医患和医生之间的沟通,降低择期手术取消率。Objective This study analyzed the causes for the cancellations of the operation on the day of elective surgery and evaluated the effects of the countermeasures by the perioperative services. Methods We retrospectively analyzed the cancelled surgical cases on the day of elective surgery in 2016,calculated the rate of surgical cancellations for patients of different ages,and examinated the specific reasons for cancellations. The Department of Anesthesiology took countermeasures against the causes. We compared the changes in the rate of surgical cancellation between 2017 and 2016,and evaluated the effectiveness of strategies adopted by the Department of Anesthesiology.Results The causes for the cancellation of elective surgery in 2016 mainly included patient self-cancellation（ 3. 8%）,incomplete preoperative examinations（ 2. 0%）,and patients not evaluated preoperatively（ 1. 6%）. Among cancelled cases,children accounted for12. 1%,adults 8. 2% and elderly people 10. 3%. The Department of Anesthesiology reduced the elective surgery cancellation rate by emphasizing effective communication with surgeons and patients,improving patients＇ preoperative preparations,and strengthening patient education,which consequently led to cancellation rate fell from 9. 1% in 2016 to 7. 9% in 2017. The difference in the rate of cancellation of elective surgery among different age groups,adult group was significantly lower between 2017 and 2016. From the analysis of the causes,self-cancellations and incomplete preoperative evaluations was significantly lower in 2017 than that in 2016. Conclusion Perioperative services should strengthen preoperative evaluation and preparation,improve communications between doctors and patients,thus lead to reduction in the rate of elective surgical cancellations.

关 键 词：择期手术 取消手术 原因分析 

分 类 号：R614[医药卫生—麻醉学]