2017年美国医疗保健研究与质量局手术并发症预防指南摘译
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摘要
<正>手术并发症给患者及其家属带来了不可估量的损失。有研究发现,3%～27%的外科患者经历了手术不良事件。通常,对此的解释是这些并发症不可避免—因为患者年纪大,且身体虚弱,然而有相当一部分并发症(某项研究中显示超过一半)是可预防的~([1-3])。2009～2012年期间,美国医疗保健研究与质量局(the Agency for Healthcare Research and Quality,AHRQ)资助了一项由1 000多家医院参与的国家
引文
1de Vries EN, Prins HA, Crolla RM, et al. Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med, 2010,363(20):1928-1937.
2Gawande AA, Thomas EJ, Zinner MJ, et al. The incidence and nature of surgical adverse events in Colorado and Utah in 1992.Surgery, 1999, 126(1):66-75.
3Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med, 2009, 360(5):491-499.
4Dixon-Woods M, Bosk CL, Aveling EL, et al. Explaining Michigan:developing an ex post theory of a quality improvement program.Milbank Q, 2011, 89(2):167-205.
5Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter related bloodstream infections in the ICU. N Engl J Med, 2006, 355(26):2725-2732.
6Pronovost PJ, Goeschel CA, Colantuoni E, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units:Observational study. BMJ, 2010, 340:c309.
7 AHRQ. Surgical complication prevention guide, AHRQ Publication No. 16(18)-0004-13-EF, 2017. Available at:https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/qua lity-patient-safety/hais/tools/surgery/guide-surgcomp.pdf.
8Pronovost PJ, Berenholtz SM, Needham DM. Translating evidence into practice:a model for large scale knowledge translation. BMJ,2008, 337:a1714.
9National Nosocomial Infections Surveillance System. National nosocomial infections surveillance(NNIS)system report, data summary from Jan 1992 through Jun 2004, issued Oct 2004. Am J Infect Control, 2004, 32(8):470-485.
10Wick EC, Hirose K, Shore AD, et al. Surgical site infections and cost in obese patients undergoing colorectal surgery. Arch Surg,2011, 146(9):1068-1072.
11Surgical care audit tools. Available at:https://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/surgery/guidesurgcomp.html.
12Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J HealthSyst Pharm, 2013, 70:195-283.
13Berrios-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg, 2017, 152(8):784-791.
14Gurses AP, Murphy DJ, Martinez EA, et al. A practical tool to identify and eliminate barriers to compliance with evidence-based guidelines. Jt Comm J Qual Patient Saf, 2009, 35(10):526-532.
15AHRQ. Barrier identification and mitigation tool. AHRQ Publication No. 16(18)-0004-10-EF, 2017. Available at:https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/qua lity-patient-safety/hais/tools/surgery/tools/surgical-complicationprevention/bim.docx.
16Pronovost PJ, Berenholtz SM, Goeschel CA, et al. Creating high reliability in health care organizations. Health Serv Res, 2006, 41(4Pt 2):1599-1617.
17Opportunity estimator. Available at:https://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/toolkit/contentcalls/opportunity_estimator-slides/oppestimatorsl.html.
18AHRQ. Applying the comprehensive unit-based safety program(CUSP)to promote safe surgery. AHRQ Publication No. 16(18)-0004-14-EF, 2017. Available at:https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/guide-appcusp.pdf.
19 Toolkit to promote safe surgery. Available at:https://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/surgery/index.html.
2Gawande AA, Thomas EJ, Zinner MJ, et al. The incidence and nature of surgical adverse events in Colorado and Utah in 1992.Surgery, 1999, 126(1):66-75.
3Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med, 2009, 360(5):491-499.
4Dixon-Woods M, Bosk CL, Aveling EL, et al. Explaining Michigan:developing an ex post theory of a quality improvement program.Milbank Q, 2011, 89(2):167-205.
5Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter related bloodstream infections in the ICU. N Engl J Med, 2006, 355(26):2725-2732.
6Pronovost PJ, Goeschel CA, Colantuoni E, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units:Observational study. BMJ, 2010, 340:c309.
7 AHRQ. Surgical complication prevention guide, AHRQ Publication No. 16(18)-0004-13-EF, 2017. Available at:https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/qua lity-patient-safety/hais/tools/surgery/guide-surgcomp.pdf.
8Pronovost PJ, Berenholtz SM, Needham DM. Translating evidence into practice:a model for large scale knowledge translation. BMJ,2008, 337:a1714.
9National Nosocomial Infections Surveillance System. National nosocomial infections surveillance(NNIS)system report, data summary from Jan 1992 through Jun 2004, issued Oct 2004. Am J Infect Control, 2004, 32(8):470-485.
10Wick EC, Hirose K, Shore AD, et al. Surgical site infections and cost in obese patients undergoing colorectal surgery. Arch Surg,2011, 146(9):1068-1072.
11Surgical care audit tools. Available at:https://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/surgery/guidesurgcomp.html.
12Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J HealthSyst Pharm, 2013, 70:195-283.
13Berrios-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg, 2017, 152(8):784-791.
14Gurses AP, Murphy DJ, Martinez EA, et al. A practical tool to identify and eliminate barriers to compliance with evidence-based guidelines. Jt Comm J Qual Patient Saf, 2009, 35(10):526-532.
15AHRQ. Barrier identification and mitigation tool. AHRQ Publication No. 16(18)-0004-10-EF, 2017. Available at:https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/qua lity-patient-safety/hais/tools/surgery/tools/surgical-complicationprevention/bim.docx.
16Pronovost PJ, Berenholtz SM, Goeschel CA, et al. Creating high reliability in health care organizations. Health Serv Res, 2006, 41(4Pt 2):1599-1617.
17Opportunity estimator. Available at:https://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/toolkit/contentcalls/opportunity_estimator-slides/oppestimatorsl.html.
18AHRQ. Applying the comprehensive unit-based safety program(CUSP)to promote safe surgery. AHRQ Publication No. 16(18)-0004-14-EF, 2017. Available at:https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/guide-appcusp.pdf.
19 Toolkit to promote safe surgery. Available at:https://www.ahrq.gov/professionals/quality-patient-safety/hais/tools/surgery/index.html.