持续的脉冲氧度测试取消实施:消除监视器过度使用的分析来自六家医院的研究数据
Jennifer A Faerber1, Rui Xiao2, Spandana Makeneni1
1Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
对于没有氧气的支气管炎的儿童,持续脉冲氧计 (cSpO2) 监测是医疗过度使用. 取消实施的努力减少了过度使用,但在战略结束后它又回来了,强调了持续干预的必要性.
科学领域:
- 儿科 儿科 儿科
- 医疗保健服务研究 医疗服务研究
- 改善医疗质量 改善医疗质量
背景情况:
- 在不需要补充氧气的支气管炎儿童中,持续脉冲氧计 (cSpO2) 监测代表了医疗过度使用的重要领域.
- 消除监控过度使用 (EMO) 研究研究了减少这种做法的策略.
研究的目的:
- 评估强化cSpO2减排策略对儿童支气管炎患者过度使用率的影响.
- 在取消积极干预后,评估减少cSpO2过度使用的可持续性.
主要方法:
- 对来自六家医院的cSpO2监测数据进行了纵向分析,分为三个阶段:基线 (P1),主动解除实施 (P2) 和维持 (P3).
- 数据包括2053个观察结果,其中P2涉及教育和审计/反策略,P3评估战略撤回后的结果.
主要成果:
- 整体调整后的cSpO2过度使用显著下降,从基线 (P1) 的53% (95% CI: 49-57) 下降到积极停止实施 (P2) 的22% (95% CI: 19-25).
- 在停止实施战略后,cSpO2过度使用在所有参与站点的维持阶段 (P3) 恢复到37% (95% CI: 33-41).
结论:
- 密集的解除实施策略可以有效地减少cSpO2在儿科支气管炎护理中的过度使用.
- 观察到的反弹效应强调了维持实践变化的挑战,以及持续监测和加强战略的必要性,以防止医疗过度使用的复发.
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