目的 基于循证构建麻醉复苏室（post anesthesia care unit,PACU）入室交接清单,为促进PACU入室交接标准化提供参考。方法 基于循证理念拟订PACU入室交接清单初稿,运用德尔菲法确定PACU入室交接清单内容,并将清单应用于PACU交接流程中,比较清单应用前后医护PACU入室交接错漏次数、床边交接时间、因交接信息缺陷导致患者出现治疗中断事件的次数,评价其应用效果。结果 2轮专家函询的有效问卷回收率均为100%,专家权威系数分别为0.895、0.915,肯德尔和谐系数分别为0.192、0.236（P<0.001）。最终形成的PACU入室交接清单包括护理交接、麻醉交接、手术交接3个一级条目和36个二级条目。PACU入室交接清单的应用,显著降低了医护交接班错漏次数、因交接信息缺陷而导致患者出现治疗中断事件的次数,缩短了医护床边交接时间（P<0.001）。结论 本研究构建的PACU入室交接清单具备科学性与实用性,可为医护人员进行规范化入室交接提供有效的工具支持。
Abstract
Objective To construct an evidence-based admission handover checklist for post anesthesia care unit (PACU), and provide reference for standardizing handover process in PACU. Methods An evidence-based draft of PACU admission handover checklist was formulated. Delphi method was used to conduct two rounds of inquiry to determine the contents of the checklist. The checklist was then applied to the handover process in PACU, and its effectiveness was evaluated by comparing the number of errors or omissions during handover, bedside handover time, and the number of treatment interruptions caused by handover information deficiencies before and after the checklist was applied. Results The effective response rates of both rounds of expert inquiry were 100%, with expert authority coefficients of 0.895 and 0.915, and Kendall’s harmony coefficients of 0.192 and 0.236, respectively(P<0.001). The final admission handover checklist for PACU consisted of 3 first-level items including nursing handover, anesthesia handover, and surgical handover, as well as 36 secondary-level items. The application of admission handover checklist significantly reduced the number of errors and omissions during the handover, as well as the number of treatment interruptions caused by inadequate handover information, and shortened bedside handover time for medical staff (P<0.001). Conclusion The admission handover checklist for PACU constructed in this study is scientific and practical, and can provide effective tool support for standardized handover of doctors and nurses.
关键词
麻醉复苏室 /
交接 /
清单 /
德尔菲法
Key words
post anesthesia care unit /
handover /
checklist /
Delphi method
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基金
华中科技大学同济医学院附属协和医院2022年药技护专项基金（F016.01003.22003.179）; 2023年湖北省自然科学基金面上项目（2023AFB952）; 华中科技大学同济医学院第一临床学院2023年教学改革研究项目（2023XH025）
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