规范周围手术抗凝管理:一个管教倡议
Kelly Rudd1, Amanda Winans2, Darren Triller3
1Oklahoma State University Center for Health Sciences Tulsa, Oklahoma, USA. kelly.rudd@okstate.edu.
Journal of thrombosis and thrombolysis
|June 26, 2023
概括
在手术期间对抗凝血药物进行管理是具有挑战性的. 这项研究实施了标准化的电子健康记录 (EHR) 过程,提高了患者的安全性,并减少了接受手术的抗凝剂患者的不良事件.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 医疗信息学 医疗信息学
背景情况:
- 对抗凝血剂的过程中断会增加出血和血栓形成的风险.
- 在手术过程中对抗凝血剂患者的管理带来了重大的临床挑战.
- 优化患者的安全性和疗效需要加强外科手术期间的抗凝治疗护理.
研究的目的:
- 在电子健康记录 (EHR) 中创建一个标准化,高效和全面的临程抗凝剂管理流程.
主要方法:
- 将IPRO-MAPPP临床决策支持逻辑改编为由护士管理的可选周围手术抗凝剂协议.
- 实施了分阶段的方法,第二阶段包括对华法林和桥接的抗凝血管理服务监督.
主要成果:
- 在手术患者群体中,30天住院或急诊室的入院人数保持在1%或以下.
- 在两个实施阶段,结果都低于公布的国家标准.
- 没有出现的抗凝固逆转剂的使用与术前护理有关.
结论:
- 这一抗凝血管理计划的逐步实施表明了选择性周围手术抗凝血治疗的高质量,低变异的护理.
- 整合EHR托管的临床决策支持和有效的沟通确保了稳定性和可持续性.
- 这种方法通过高质量的周围手术抗凝剂管理来优化患者的治疗结果.
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