This review examined published literature on the structure and function of bedside procedure services and their impact on clinical and educational outcomes (PROSPERO ID: 192466).
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, multiple databases were searched for publications from 2000 to 2021.
Thirteen single-center studies were identified, including 12 observational studies and 1 randomized trial. Data were synthesized in tabular and narrative format. Services were typically staffed by hospitalists or pulmonologists. At a minimum, each offered paracentesis, thoracentesis, and lumbar puncture. While there was considerable heterogeneity in service structures, these broadly fit either Model A (service performing the procedure) or Model B (service supervising the primary team). Procedure services led to increases in procedure volumes and self-efficacy among medical residents. Assessment of clinical outcomes was limited by heterogeneous definitions of complication rates and by sparse head-to-head data involving suitable comparators. Published data pointed to high success rates, low complication rates, and high patient satisfaction, with a recent study also demonstrating a decreased length of stay.
There are relatively few published studies describing the characteristics of bedside procedure services and their impact on clinical and educational outcomes. Limited data point to considerable heterogeneity in service design, a positive impact on medical trainees, and a positive impact on patient-related outcomes.
这篇综述研究了有关床边手术服务的结构和功能及其对临床和教育结果的影响的已发表文献(PROSPEROID:192466)。
使用首选报告项目进行系统审查和荟萃分析框架,从2000年到2021年,搜索了多个数据库的出版物。
确定了13项单中心研究,包括12项观察性研究和1项随机试验.数据以表格和叙述格式综合。服务通常由医院或肺科医师提供。至少,每个人都提供了穿刺,胸腔穿刺术,还有腰椎穿刺.虽然服务结构存在相当大的异质性,这些大致适合模型A(执行程序的服务)或模型B(监督主要团队的服务)。程序服务导致医疗居民的程序量和自我效能感增加。临床结果的评估受到并发症发生率定义的异质性以及涉及合适比较器的稀疏头对头数据的限制。公布的数据显示成功率很高,并发症发生率低,患者满意度高,最近的一项研究也表明住院时间缩短。
描述床边手术服务的特征及其对临床和教育结果的影响的已发表研究相对较少。有限的数据表明服务设计存在相当大的异质性,对医疗学员的积极影响,以及对患者相关结局的积极影响。