PDF(Pubmed)
Abstract：
Suboptimal teamwork in the operating room (OR) is a contributing factor in a significant proportion of preventable complications for surgical patients. Specifying behaviour is fundamental to closing evidence-practice gaps in healthcare. Current teamwork interventions, however, have yet to be synthesized in this way. This scoping review aimed to identify actionable strategies for use during surgery by mapping the existing literature according to the Action, Actor, Context, Target, Time (AACTT) framework. The databases MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Cochrane, Scopus, and PsycINFO were searched from inception to April 5, 2022. Screening and data extraction were conducted in duplicate by pairs of independent reviewers. The search identified 9,289 references after the removal of duplicates. Across 249 studies deemed eligible for inclusion, eight types of teamwork interventions could be mapped according to the AACTT framework: bundle/checklists, protocols, audit and feedback, clinical practice guidelines, environmental change, cognitive aid, education, and other), yet many were ambiguous regarding the actors and actions involved. The 101 included protocol interventions appeared to be among the most actionable for the OR based on the clear specification of ACCTT elements, and their effectiveness should be evaluated and compared in future work.
摘要：
手术室（OR）中的次优团队合作是导致手术患者可预防并发症的重要因素。指定行为对于缩小医疗保健中的证据与实践差距至关重要。当前的团队合作干预措施，然而,还没有以这种方式合成。本范围审查旨在通过根据行动绘制现有文献来确定手术期间使用的可操作策略，演员,上下文,目标,时间（AACTT）框架。数据库MEDLINE（医学文献分析和在线检索系统），Embase,护理和相关健康文献累积指数(CINAHL)，教育资源信息中心(ERIC),科克伦,Scopus,和PsycINFO从开始到2022年4月5日进行了搜索。筛选和数据提取由成对的独立审阅者一式两份进行。删除重复项后，搜索确定了9,289个参考。在249项被认为有资格纳入的研究中，根据AACTT框架，可以映射八种类型的团队合作干预：捆绑/清单，协议,审计和反馈，临床实践指南，环境变化,认知援助，教育,和其他)，然而，许多人对所涉及的演员和行动模棱两可。根据ACCTT元素的明确说明，包含的101种协议干预措施似乎是OR最可行的措施之一，在今后的工作中，应评估和比较其有效性。
