新形势下降低非计划重返手术室再手术率方案和防范策略  

Plan and prevention strategy for reducing unplanned return to operating room and reoperation rate in the new era

作　　者：朱首伦 阮名琪 何志鹏 ZHU Shoulun;RUAN Mingqi;HE Zhipeng(Department of Medical,the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong Province,Guangzhou510120,China;Health Management College,Guangzhou Huashang College,Guangdong Province,Guangzhou510120,China;Hospital Infection Management Office,the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong Province,Guangzhou510120,China)

机构地区：[1]广州中医药大学第二附属医院广东省中医院医务处,广东广州510120 [2]广州华商学院健康管理学院,广东广州510120 [3]广州中医药大学第二附属医院广东省中医院院感办,广东广州510120

出　　处：《中国医药导报》2025年第6期176-179,190,共5页China Medical Herald

摘　　要：通过分析新形势下国内外非计划重返手术室再手术率现状,创新性提出制订降低非计划重返手术室再次手术率的方案和防范策略,建立贯穿术前-术中-术后全链条监管的非计划重返手术室再手术实时监管流程,加强术前风险因素排查和管理,严格术中风险管理,强化术后风险识别和管理,创新性提出构建非计划重返手术室再手术“一核二级四控”安全预防体系,打造人人都是手术“本质安全员”的理念,同时完善监控体系与持续改进方案。结合防范策略使用前后4年来的成效分析,通过多措并举,提前1年完成非计划重返手术室再手术率不高于1.8‰的目标,且远低于国家要求控制的标准,提高手术质量,为助力落实《全面提升医疗质量行动计划(2023—2025年)》作出有意义的探索。By analyzing current situation of unplanned return to operating room and reoperation rate both domestically and internationally in the new era,innovatively propose the development of plan and prevention strategy for reducing unplanned return to operating room and reoperation rate,establish a real-time monitoring process for unplanned return to operating room and reoperation that runs through full-chain of preoperative,intraoperative,and postoperative supervision,strengthen preoperative risk factor screening and management,strict intraoperative risk management,strengthen postoperative risk identification and management,innovatively propose to build a“one nuclear,two levels and four controls”safety prevention system for unplanned return to operating room and reoperation,creating the concept that everyone is an“intrinsic safety officer”in surgery,simultaneously improve monitoring system and continuous improvement plan.Based on effectiveness analysis of prevention strategies over the past four years,through multiple measures,the goal of achieving an unplanned return to operating room and reoperation rate of no more than 1.8‰one year ahead of schedule is achieved,and it is far below national control standards,improving the quality of surgery,and making meaningful exploration to help implement Comprehensive Action Plan for Improving Medical Quality(2023—2025).

关 键 词：非计划重返手术室再手术率 全链条非计划重返手术室再手术风险管控 “一核二级四控” “本质安全员” 

分 类 号：R197.32[医药卫生—卫生事业管理]