在临床教学单位实施早期预警系统,以减少意外死亡
Tara Swami1, Ali Shams1, Matthew Mittelstadt1
1University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada.
早期预警系统 (EWS) 可以帮助检测患者的病情恶化. 虽然实施显示了一些好处,但为了改善患者护理,需要进一步参与利益相关者和电子文档.
科学领域:
- 临床医学 临床医学
- 改善医疗保健质量 改善医疗保健质量
- 患者安全 患者安全
背景情况:
- 在住院患者中早期发现临床恶化对于及时干预至关重要.
- 现有的早期预警系统 (EWS) 主要用于紧急和儿科环境,对其在一般内科病房的应用数据有限.
- 由于缺乏标准化工具来识别患者早期病情恶化,因此需要开发和评估此类系统.
研究的目的:
- 在一般内科病房实施和评估早期预警系统 (EWS) 的实用性.
- 评估EWS实施对患者结果的影响,并确定实施挑战.
- 通过早期识别临床恶化来改善患者护理.
主要方法:
- 在第三级护理医院的临床教学部门进行了一项质量改进项目.
- 在EWS实施前24周和EWS实施后55周收集了患者事件的数据.
- 计划,做,研究,行动循环被采用,包括假试验,团队教育,坚持评估和结果评估.
主要成果:
- 实施阶段显示,意外死亡 (每周0.46至0.25) 和心脏骤停 (每周0.13至0.25) 略有下降.
- 污水处理和观察单位转移率保持相对稳定.
- 关键护理转移的边际增加 (0.7到0.82每周).
结论:
- 早期预警系统 (EWS) 通过促进早期干预来提高患者护理的潜力.
- 建议提高利益相关者的参与度,并整合电子生命体征文档,以优化EWS的采用和有效性.
- 进一步的研究是有必要的,以充分理解影响,并优化在一般医疗病房实施EWS.
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