非手术室麻醉中的危机资源管理

摘要(中文译文)

随着技术的进步，30-50%的麻醉病例已转移至手术室外麻醉（NORA）场所。NORA的挑战包括患者复杂性和工效学复杂性，这可使常规和紧急情况下的麻醉管理变得复杂。本综述旨在总结关于NORA危机资源管理（CRM）的当前证据。NORA中的CRM以在非主要为提供麻醉护理而设计的地点与不熟悉的团队合作为特征。设备和人员资源可能有限，或与手术室中可用的资源不同。尽管很少有研究直接评估CRM在NORA环境中的效果，但关于危机模拟培训在改善团队行为、角色明确性和护理及时性方面的效用已达成广泛共识。此外，团队建设、流程改进和认知辅助工具的开发可以是精心实施的CRM培训项目的副产品。CRM可以应对NORA中的若干关键挑战，包括在不熟悉的团队中以及非主要为麻醉护理而设计的地点工作。研究的匮乏可能反映了在以生产为驱动的环境中实施跨专业CRM培训的困难。未来的研究应探索NORA中CRM培训的障碍和成功实施策略。

Abstract

With advances in technology, 30-50% of anesthesia cases have moved to nonoperating room anesthesia (NORA) sites. NORA challenges include patient and ergonomic complexity, which can complicate anesthesia care during routine and emergency situations. This review aimed to summarize current evidence on NORA crisis resource management (CRM). CRM in NORA is characterized by working with unfamiliar teams in locations not primarily designed for delivering anesthesia care. Equipment and personnel resources may be limited or different from what is available in the operating room. While few studies directly evaluate the effect of CRM in NORA settings, there is widespread consensus about the utility of crisis simulation training to improve team behaviors, role clarity, and timeliness of care. In addition, team building, process improvement, and the development of cognitive aids can be byproducts of well-executed CRM training programs. CRM can address several of the key challenges in NORA, including working in unfamiliar teams and in locations not primarily designed for anesthesia care. The paucity of studies may reflect the difficulty of implementing interprofessional CRM training in production-driven settings. Future research efforts should explore barriers to CRM training and successful implementation strategies in NORA.

如何引用

Current opinion in anaesthesiology 的其他文献

• 将加速康复外科原则应用于非手术室麻醉环境：原理、当前证据和未来方向
• 右美托咪啶：最新情况
• 麻醉中的衰弱
• 儿科气道管理的未来