缩短非计划,紧急剖腹产的决定到切口时间
Lina Tibavinsky Bernal1, Christina D Yarrington, Ziming Xuan
1Boston Medical Center, and the Boston University School of Medicine, Boston, Massachusetts.
Obstetrics and gynecology
|June 8, 2023
概括
标准化紧急剖腹产流程大大缩短了决定切口的时间. 这项质量改善计划改善了母亲和新生儿的结果,特别是黑人和西班牙裔患者.
科学领域:
- 产科和妇科 产科和妇科
- 提高质量 提高科学 提高质量
- 患者安全 患者安全
背景情况:
- 紧急的,非预定的剖腹产需要快速干预,以优化母亲和胎儿的福祉.
- 现有的程序前协议可能会导致延迟,影响临床结果.
- 护理途径的标准化对于提高紧急产科程序的效率至关重要.
研究的目的:
- 实施和评估一种标准化的算法,用于紧急的,非计划的剖腹产分娩.
- 减少从临床决定到皮肤切口的平均时间 (决策到切口时间).
- 通过简化手术前的流程,提高母亲和胎儿的结果.
主要方法:
- 一个质量改进项目,利用从2019年5月到2021年5月的中断时间序列分析.
- 开发一种用于紧急剖腹产的多学科标准算法.
- 测量决策到切口时间,5分钟的阿帕格分数和定量血液损失,按患者的种族和种族分层.
主要成果:
- 平均决策到裁决时间从实施前的88分钟减少到实施后的50分钟.
- 在黑人非西班牙裔和西班牙裔患者群体中观察到显著的时间缩短.
- 实施后,5分钟的阿普加尔评分对于胎儿的指示显著更高.
结论:
- 一个标准化的算法有效地减少了紧急剖腹产的决定到切口的时间.
- 该倡议在关键的过程和结果指标方面取得了改进.
- 紧急产科程序的标准化是提高患者安全和结果的可行策略.
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