手术后阿片类药物管理协议是否可持续? 一个为期两年的质量改进项目的结果
Alexa D Melucci1, Anthony Loria2, Holli Swanson3
1Surgical Health Outcomes Research Enterprise, Department of Surgery, University of Rochester Medical Center, NY; Department of Surgery, University of Rochester Medical Center, NY.
Surgery
|July 5, 2023
概括
阿片类药物管理协议维持了两年多的阿片类药物处方减少,而没有增加资源. 这表明了阿片类药物减少策略在手术环境中的长期可行性.
科学领域:
- 改善外科手术的质量
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 阿片类药物管理协议旨在制过度处方,但通常需要在一年内重新评估.
- 关于这些阿片类药物减少策略的长期可持续性的数据有限.
研究的目的:
- 评估阿片类药物处方趋势在实施管理协议后的一年后的可持续性.
- 评估质量改善倡议对选择性结直肠手术患者阿片类药物处方的影响.
主要方法:
- 一个第三级护理中心制定了共识释放阿片类药物处方指南.
- 一项前性质量改进研究对接受选择性切除术,直肠切除术和门相关手术的患者进行.
- 收集的数据包括协议遵守,患者控制的止痛使用,神经阻塞率,住院阿片类药物利用率,疼痛评分和阿片类药物排放量.
主要成果:
- 在两年内,达到了88.6%的合规性,阿片类药丸排放量减少了43.6%.
- 观察到手术内神经阻塞,患者控制的止痛和住院阿片类药物使用的显著下降.
- 阿片类药物补充电话保持稳定,92%的患者报告对止痛药的满意度.
结论:
- 减少阿片类药物处方持续了两年,没有额外的资源配置.
- 研究结果表明,成功的阿片类药物减少方案可以使机构重新分配质量改善资源.
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