第3次がんセンターにおける終末期医療の改善のための監査
Conor D Moloney1, Hailey K Carroll1, Elaine Cunningham2
1Cork University Hospital, Wilton, T12 DC4A Cork, Ireland.
Current oncology (Toronto, Ont.)
|August 27, 2025
まとめ
ターゲットを絞った介入の実施は,がん患者の終末期ケア (EoLC) の質を大幅に改善しました. 再監査では 患者のケアが持続的に改善され 終末期のケアが不十分であることが示されました
科学分野:
- 腫瘍学
- 緩和ケア
- 医療の質の向上
背景:
- 高品質の終末期ケア (EoLC) は腫瘍学において不可欠ですが,しばしば見過ごされています.
- 2021年の監査では,COVID-19のパンデミック中に癌患者の有意なEoLCの欠乏が確認されました.
研究 の 目的:
- 高等がんセンターにおけるEoLCの質への介入の影響を評価する.
- プロフォーマ,チェックリスト,教育,拡大委員会を実施した後の改善を評価する.
主な方法:
- 2022年7月から2023年4月の間に死亡した72人の患者の遡及的な再監査.
- オックスフォード品質指標を用いたEoLC品質の評価
主要な成果:
- 初期監査と比較してEoLCの品質が著しく改善された (p=0.021).
- 患者の願望の文書化 (48.8% 対 24.2%) と患者介護の紹介 (68.3% 対 10.6%) が増加した.
- 貧困層のEoLCを21.2%から8.3%に削減する.
結論:
- 単純な介入,再監査,そして学際的なコミットメントは,EoLCを効果的に強化します.
- 生命の終わりの介護の質の持続的な改善は,構造化された品質イニシアチブによって達成可能である.
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