摘要
目的分析影响眼科日间手术运行效率的因素,从而降低日间手术取消率,提高日间手术中心的工作效率。方法回顾性分析2018年6月至2021年5月(共36个月)眼科日间手术取消情况。统计手术临时取消与患者术前准备及眼科疾病之间的关系,并根据手术临时取消的医疗因素、管理因素、患者个人因素等,将取消因素分为可控因素与不可控因素,分析手术取消率与各因素之间的关系。2021年6~11月,针对可控因素制定相应的改进措施,并与改进前36个月数据进行对比,以评估改进措施的有效性。结果2018年6月至2021年5月眼科日间手术总量为78352例,手术取消总量为4013例,取消率为5.12%。导致取消的原因包括:患者因素(3030例,75.50%)、医疗因素(916例,22.83%)以及管理因素(67例,1.67%)。取消率排名前5位的疾病分别为:白内障(2627例,65.47%)、视网膜病(561例,13.98%)、青光眼(257例,6.41%)、斜视(172例,4.29%)、眼整形相关疾病(105例,2.63%)。可控因素主要为患者因素中的知识缺乏和应激反应,不可控的主要因素为患者病情变化和疫情因素。2021年6~11月,针对可控因素制定了相应改进措施后,手术取消率降为4.73%,较前无统计学差异(χ^(2)=3.647,v=1,P=0.056)。进一步对取消手术中各种原因占比进行分析,将各种手术取消原因分别归纳为可控因素及不可控因素,处理组在可控因素与不可控因素分布方面与处理前组有统计学差异(χ^(2)=34.925,v=1,P=0.000)。处理组可控因素占比与处理前相比有明显降低。而相反,不可控因素的占比在处理组中明显升高。可控因素中,患者放弃/决绝手术,术前血压高2个因素在处理组中占比明显降低(χ^(2)=1236.86,P=0.000;χ2=4.283,P=0.028),而准备不充分因素在处理组中占比明显升高(χ^(2)=51.685,P=0.000)。不可控因素中,疫情,医生取消,全身疾病因素,无家属陪同,转住院手术5个因素占比均明显升高(χ^(
Objective To analyze the factors affecting the efficacy of ophthalmic day surgery,thus reducing the cancellation rate of day surgery and improve the work efficiency.Methods The causes of canceling ophthalmic day surgery from June 2018 to May 2021(36 months)were retrospectively analyzed.The correlation between the cancellation of surgery and the patient’s preoperative preparation and ophthalmic diseases was analyzed.Medical,management,and personal factors for canceling ophthalmic day surgery were divided into controllable and uncontrollable factors.Improvement measures for controllable factors were made from June to November 2021,and relevant data during this period were compared with previous data from June 2018 to May 2021.Results From June 2018 to May 2021,a total of 78,352 ophthalmic day surgeries were performed,and a total of 4,013 surgeries were canceled,with a cancellation rate of 5.12%.Patient factors,medical factors and management factors for canceling ophthalmic day surgery were detected in 3,030(75.50%),916(22.83%)and 67(1.67%)cases,respectively.The top 5 ophthalmic diseases with cancellations were cataract(2,627 cases,65.47%),retinopathy(561 cases,13.98%),glaucoma(257 cases,6.41%),strabismus(172 cases,4.29%),and ocular plastic surgery-related diseases(105 cases,2.63%).The controllable factors were mainly personal factors like the lack of knowledge and stress response of patients,while the uncontrollable factors were changes in patients’condition and epidemic situation.From June to November 2021,the cancellation rate of ophthalmic day surgery decreased to 4.73%after corresponding improvement measures were developed for controllable factors,although no significant difference was obtained(χ^(2)=3.647,V=1,P=0.056).A significant difference was detected in the distribution of controllable and uncontrollable factors between pre-improvement measure group and improvement measure group(χ^(2)=34.925,V=1,P=0.000).The proportion of controllable factors in the improvement measure group was significantly lower
作者
杨小晓
马张芳
刘敬花
张宛侠
张岩
于佳
刘晴
薛智伟
周丽娟
YANG Xiaoxiao;MA Zhangfang;LIU Jinghua(Ophthalmology Center,Beijing Tongren Hospital,CMU,Beijing 100730,China)
出处
《河北医药》
CAS
2023年第8期1254-1258,共5页
Hebei Medical Journal
基金
国家重点研发计划项目(编号:2017YFA0104103)
首都医科大学附属北京同仁医院护理院内基金(编号:2020-YJJ-HLL-011)。
关键词
眼科
日间手术
手术取消
原因
改进措施
ophthalmology
day surgery
cancellation of surgery
reason
improvement plan
