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ID: 377 (Conflict of Interest: K)

Kognitive und soziale Kompetenzen im Operationssaal: Eine Meta-Analyse patientenrelevanter Endpunkte

S.Leuschner1, M.Leuschner1, S.Kropf2, P. M.Vogt3, A. D.Niederbichler1
1AMEOS Klinikum Halberstadt, Halberstadt
2Universitätsklinikum Magdeburg A.ö.R., Magdeburg
3Medizinische Hochschule Hannover, Hannover

Einleitung

Surgical errors are often the result of a break-down of non-technical skills (NTS) rather than a failure of technical ability. The aim of this meta-analysis was to investigate whether NTS training of theatre staff improved patient outcomes.

Material und Methoden

A systematic review with the aim of identifying all interventional studies of NTS training was performed. Primary outcomes included mortality, complication rate, length of hospital stay and readmission rate. Secondary outcomes were changes in staff non-technical skills, technical performance and utilisation of the surgical safety check list. For dichotomous data odds ratios and their 95% confidence intervals were calculated. For continuous data mean differences were used.

Ergebnisse

Nine studies were included in this review of which five could be analysed in a meta-analysis. After non-technical skills training there was no reduction in complication rate (OR 0.92 [0.65, 1.29], p=0.62), length of hospital stay (-0.34 days [-0.87, 0.19], p=0.21) or readmission rate (OR 0.90 [0.63, 1.28], p=0.56). Three studies reported mortality. A randomised, controlled trial found no difference in mortality after training. Of the secondary outcomes there was an increase in staff NTS measured using NOTECHS II (+5.03 points [1.27; 8.79], p=0.009). There was no change in technical performance (-2.25 [-9.62; 4.52], p=0.48). The adherence to the surgical safety checklist was improved in almost all studies.

Schlussfolgerung

No changes in patient outcomes were found after non-technical skills training. Future studies should further investigate the relationship between NTS and patient safety.