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Comparison of anaesthesia‐related outcomes in patients monitored by newly recruited nurse anaesthetists and anaesthesiologists: An observational study

医学 恶心 倾向得分匹配 麻醉 呕吐 回顾性队列研究 观察研究 体质指数 内科学
作者
Qinqin Cao,Chengjuan Fan,Xiaolei Ren,Shuling Bai,Hemin Dong,Min Wei,Haihong Meng
出处
期刊:Journal of Clinical Nursing [Wiley]
卷期号:33 (4): 1482-1492
标识
DOI:10.1111/jocn.16940
摘要

Abstract Aims To compare anaesthesia‐related outcomes between patients monitored by newly recruited nurse anaesthetists and those monitored by newly recruited anaesthesiologists. Design This was a retrospective study. Methods We conducted a retrospective study that collected demographic information on newly recruited nurse anaesthetists and anaesthesiologists between 2017 and 2022 and recorded information on patients within 6 months of monitoring. Postoperative pain, emergency agitation, nausea, and vomiting were designated anaesthesia‐related outcomes. Propensity score matching was used to adjust for covariates. The study adhered to the STROBE guidelines. Results The study's statistical analysis included 4483 patients monitored by 22 newly recruited nurse anaesthetists and 4959 patients monitored by 23 newly recruited anaesthesiologists. Compared with patients monitored by newly trained anaesthesiologists, the patients monitored by nurse anaesthetists were younger (42.07 ± 20.00 vs. 47.39 ± 18.45 years, p < 0.001) and had a lower body mass index (23.56 ± 4.46 vs. 24.19 ± 4.25, p < 0.001). Patients monitored by anaesthesiologists had a greater proportion of women (61.62% vs. 59.25%, p < 0.001), a high proportion of ASA III and ASA IV (17.1% vs. 8.88%, p < 0.001), and a longer mean surgery duration (78.65 ± 59.01 vs. 70.70 ± 60.65 min, p < 0.001). After propensity score matching was used to adjust for covariates, no statistically significant differences were found in the prevalence of postoperative pain, emergency agitation, or postoperative nausea and vomiting between the two groups ( p < 0.05). Conclusion Nurse anaesthetists monitoring alone during anaesthesia maintenance is feasible and safe. The two groups had no significant differences in the incidence of postoperative pain, emergency agitation, or postoperative nausea and vomiting. Relevance to Clinical Practice The shortage of anaesthesiologists leads to heavy work burden and high incidence of occupational burnout among anaesthesiologists. The study found that it was safe for nurse anaesthetists to perform anaesthetic monitoring alone in the operating room under the supervision of the attending anaesthesiologist and did reduce the burden of anaesthesiologists’ work. The results of the current study contribute to the expansion of occupational categories for nurse anaesthetists in countries where anaesthesiologists are in short supply. It provides new ideas for hospital administrators and policy‐makers to formulate medical and nursing service policies.
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