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Objective:To explore the value of nursing checklist in posterior surgery for thoracolumbar fracture with general anesthesia under prone position.Methods:A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fracture admitted to Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from June 2018 to May 2020. There were 80 males and 26 females，with age range of 25-57 years［（48.6 ± 11.9）years］. Segments of injury were located at T 11 in 18 patients，at T 12 in 26，at L 1 in 21，at L 2 in 25 and at L 3 in 16. All patients were treated with thoracolumbar posterior screw fixation under general anesthesia. Of all，51 patients received conventional postural nursing from June 2018 to May 2019（control group），and 55 patients received prone position nursing scheme for general anesthesia on the basis of conventional postural nursing from June 2019 to May 2020（verification group）. The incidence of postoperative complications including stress injury，brachial plexus injury，ulnar nerve injury and ocular discomfort as well as length of hospital stay and patients’ satisfaction were compared between the two groups. Visual analogue scale（VAS）and Oswestry disability index（ODI）were also used to measures outcome at postoperative 3 months. Results:All patients were followed up for 8-12 months［（10.5±0.9）months］. Verification group and control group showed significant differences in the incidence of stress injury（4%∶29%），brachial plexus injury（4%∶16%）and ocular discomfort consisiting of tears（2%∶12%），foreign body sensation（0%∶4%）and dryness（4%∶16%）（ P < 0.05），not in ulnar nerve injury and blurred vision. Length of hospitalization in verification group was（7.0±1.3）days，significantly shorter than that in control group［（9.9±1.9）days］（ P < 0.05）. Satisfaction of patients in verification group and control group was 85%（47/55）and 69%（35/51），respectively（ P < 0.05）. At 3 months postoperatively，VAS in verification group［（1.9 ± 0.8）points］was significantly lower than that in control group［（3.5±1.1）points］（ P < 0.05），and ODI was similar between the two groups（ P > 0.05）. Conclusions For patients with thoracolumbar fracture treated by posterior surgery with general anaesthesia under prone position，nursing checklist helps reduce occurrence of the related complication，shorten length of hospital stay，improve patient satisfaction，reduce postoperative pain and promote rehabilitation.
RESUMO
Objetivo: Avaliar itens de segurança na cirurgia cardíaca em pacientes de um hospital público. Método: Estudo descritivo e transversal. A coleta de dados, desenvolvida em 2012, foi realizada em uma instituição hospitalar pública estadual, onde foram observadas 30 cirurgias cardíacas por meio de um roteiro embasado nas 3 fases do checklist de cirurgia segura da Organização Mundial da Saúde (OMS), com alternativas descritas como "em conformidade" e "em não conformidade". Resultados: Os resultados de não conformidade corresponderam a 56% dos casos antes da indução anestésica, 57% antes do procedimento e 75% na saída da sala de cirurgia. Conclusão: O checklist da OMS se faz necessário, porém, o treinamento profissional e a educação permanente constituem a linha mestra para a formação de uma equipe de saúde crítica e consciente do seu papel na segurança dos pacientes.
Objective: Evaluation of security items in cardiac surgery at a public hospital. Methods: Cross-sectional descriptive study. Data collection was performed in 2012 at a public state-owned hospital, where 30 cardiac surgeries were observed and evaluated through a script based on the 3 steps of the World Health Organization (WHO) surgical safety checklist. Procedures were categorized as "in conformance" or "in non-conformance." Results: Non-conformance results made up 56% of cases before anesthetic induction, 57% prior to the procedure, and 75% of cases before leaving the operating room. Conclusions: Though the WHO checklist is indispensable, professional training and continuing education remain crucial for training a critical health care team that is aware of its role in securing patient safety.
Objetivo: Evaluar ítems de seguridad en la cirugía cardíaca en pacientes de un hospital público. Método: Estudio descriptivo y transversal. La colecta de datos, desarrollada en 2012, fue realizada en una institución hospitalaria pública estadual, donde fueron observadas 30 cirugías cardíacas por medio de un itinerario basado en las 3 fases del checklist de cirugía segura de la Organización Mundial de la Salud (OMS), con alternativas descritas como "en conformidad" y "en no conformidad". Resultados: Los resultados de no conformidad correspondieron al 56% de los casos antes de la inducción anestésica, un 57% antes del procedimiento y un 75% en la salida del quirófano. Conclusión: El checklist de la OMS se hace necesario, sin embargo, la capacitación profesional y la educación permanente constituyen la línea maestra para la formación de un equipo de salud crítico y consciente de su papel en la seguridad de los pacientes.