相关实验视频
用于付费绩效计划的高血压绩效测量是否会惩罚那些照顾医疗复杂患者的人?
Laura A Petersen1, Lechauncy D Woodard, Louise M Henderson
1MPH, Health Services Research and Development (152), Houston Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA. laurap@bcm.edu
Circulation
|June 3, 2009
概括
包括高血压在内的多种慢性疾病患者获得了更高质量的护理. 患者对护理的满意度并没有根据同时存在的疾病数量而有所不同.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床质量测量临床质量测量
- 慢性疾病管理 慢性疾病管理
背景情况:
- 人们担心,绩效测量可能会使照顾多种慢性病患者的医疗保健提供者处于不利地位.
- 这项研究调查了伴随性疾病对高血压护理质量和患者感知的影响.
研究的目的:
- 检查共存疾病如何影响高血压护理的质量.
- 评估患者对护理质量的看法,与并发症负担相关.
主要方法:
- 分析了141,609名患有高血压的退伍军人的队列.
- 患者根据高血压一致和/或不一致的并发症进行了分类.
- 后勤回归评估了并发症类型/数量和获得高质量的高血压护理之间的关联.
主要成果:
- 与没有协同,不协同或两种类型的并发症患者相比,接受高质量的高血压护理的几率更高.
- 这些发现在调整疾病严重程度和医疗保健利用率后仍然存在.
- 患者满意度评级与并发性疾病的存在或数量无关.
结论:
- 与人们的担忧相反,具有更大的医疗复杂性的患者更有可能获得高质量的高血压护理.
- 患者对护理质量的主观评价与并发症状况没有差异.
- 结果表明,照顾复杂患者的提供者可能不会受到当前质量指标的惩罚.
相关概念视频
Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
Errors occurring during blood pressure monitoring
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Special considerations while measuring blood pressure
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...