Intraoperative scrub nurse turnover in orthopaedic surgery procedures: An opportunity for improved operating room efficiency

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES
J.R. Lex , B. Entezari , J. Toor , A. Abbas , M. Nousiainen , C. Rahman , C. Whyne , B. Ravi
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引用次数: 0

Abstract

Background

Scrub nurses play a crucial role in facilitating orthopaedic surgeries, and thus intraoperative scrub nurse turnover may disrupt the workflow of the surgical team and prolong duration of surgery (DOS). The purpose of this study was to quantify the impact of intraoperative scrub nurse turnover on operative time of orthopaedic surgeries lasting less than 3 h in duration.

Methods

Prospectively collected databases from two institutions were retrospectively queried to identify all orthopaedic procedures of maximum mean duration of 180 min from March 4th, 2018 to August 31st, 2022. Cases were divided into two groups, those with scrub nurse turnover and those without. Propensity score matching was conducted to match groups by surgeon, hospital, patient age, gender, and ASA classification. Unpaired t-tests were used to compare mean DOS for each surgical procedure. Average treatment effect on treated (ATET) with 95% confidence intervals (CIs) were calculated.

Results

Scrub nurse turnover significantly prolonged DOS for both bone forearm facture open reduction and internal fixation (ORIF) (ATET = 21.08, p = 0.001), ankle ORIF (ATET = 21.26, p < 0.001), clavicle ORIF (ATET = 16.16, p = 0.028), femur intramedullary nail (ATET = 11.52, p = 0.003), rotator cuff repair (ATET = 16.88, p < 0.001), partial discectomy (ATET = 10.52, p = 0.001), total knee arthroplasty (TKA) (ATET = 5.69, p < 0.001), anterior total hip arthroplasty (THA) (ATET = 8.80, p < 0.001), lateral THA (ATET = 7.02, p < 0.001), and uncemented hip hemiarthroplasty (ATET = 16.79, p = 0.049).

Conclusion

Intraoperative scrub nurse turnover significantly prolongs surgical times in orthopaedic surgeries lasting up to 3 h in duration. This highlights the importance of developing strategies to prevent intraoperative scrub nurse turnover to improve OR efficiency and decrease healthcare costs.

骨科手术过程中术中擦洗护士的更替:提高手术室效率的机会
背景擦洗护士在促进骨科手术方面发挥着至关重要的作用,因此术中擦洗护士的流动可能会扰乱手术团队的工作流程并延长手术时间(DOS)。本研究旨在量化术中擦洗护士更替对持续时间少于 3 小时的骨科手术的手术时间的影响。方法通过回顾性查询从两家机构收集的数据库,找出从 2018 年 3 月 4 日至 2022 年 8 月 31 日平均持续时间最长为 180 分钟的所有骨科手术。病例被分为两组,即有擦洗护士更替和没有擦洗护士更替的病例。根据外科医生、医院、患者年龄、性别和 ASA 分类进行倾向得分匹配。采用非配对 t 检验比较每种手术方法的平均 DOS。结果擦洗护士的流动显著延长了骨前臂骨折切开复位内固定术(ORIF)的DOS(ATET = 21.08,p = 0.001)、踝关节 ORIF(ATET = 21.26,p < 0.001)、锁骨 ORIF(ATET = 16.16,p = 0.028)、股骨髓内钉(ATET = 11.52,p = 0.003)、肩袖修复(ATET = 16.88,p < 0.001)、部分椎间盘切除术(ATET = 10.52,p = 0.001)、全膝关节置换术(TKA)(ATET = 5.69,p < 0.001)、前路全髋关节置换术(THA)(ATET = 8.80,p < 0.001)、侧路全髋关节置换术(THA)(ATET = 7.02,p < 0.结论在持续时间长达 3 小时的骨科手术中,术中擦洗护士的更替显著延长了手术时间。这凸显了制定策略防止术中擦洗护士流失以提高手术室效率和降低医疗成本的重要性。
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来源期刊
CiteScore
1.70
自引率
8.30%
发文量
83
审稿时长
57 days
期刊介绍: Revista de Calidad Asistencial (Quality Healthcare) (RCA) is the official Journal of the Spanish Society of Quality Healthcare (Sociedad Española de Calidad Asistencial) (SECA) and is a tool for the dissemination of knowledge and reflection for the quality management of health services in Primary Care, as well as in Hospitals. It publishes articles associated with any aspect of research in the field of public health and health administration, including health education, epidemiology, medical statistics, health information, health economics, quality management, and health policies. The Journal publishes 6 issues, exclusively in electronic format. The Journal publishes, in Spanish, Original works, Special and Review Articles, as well as other sections. Articles are subjected to a rigorous, double blind, review process (peer review)
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