减少手术后护理人员对儿科泌尿外科提供者的下班电话:一项质量改善研究
Amanda Raines1, Jennifer Ahn1, Mark Cain1
1Division of Pediatric Urology, Seattle Children's Hospital, Seattle, WA, USA; Department of Urology, University of Washington, Seattle, WA, USA.
Journal of pediatric urology
|July 23, 2023
概括
改善儿科护理,这一质量改进项目通过澄清术后指令,减少了非紧急护理人员的呼叫. 文档标准得到了满足,但总体呼叫量保持不变.
科学领域:
- 提高儿童医疗保健质量 提高儿童医疗保健质量
- 患者沟通策略 患者沟通策略
- 医疗保健运营管理 医疗保健运营管理
背景情况:
- 办公时间后的护理人员电话对于儿科患者护理至关重要,但对于非紧急问题往往被过度利用.
- 目前的系统缺乏明确的指导方针,导致经常需要术后问题和不一致的文档.
- 一项旨在提高质量的倡议,旨在减少非紧急电话和增强电话遭遇文档.
研究的目的:
- 为了减少在工作时间后接到的非紧急护理人员电话的数量.
- 提高电话接触记录的一致性和标准化.
- 评估更新后手术指令对呼叫量和紧急性的影响.
主要方法:
- 一个单一的机构,使用计划-做-研究-行动 (PDSA) 周期的多阶段质量改进项目.
- 第一个阶段:为电话接触开发了一个标准化的笔记模板.
- 第二阶段:更新了手术后出院说明书,明确指导了何时在工作时间后与临床医生联系.
主要成果:
- 在实施更新指令后,术后电话的比例从66%大幅下降到38% (p < 0.001).
- 非紧急电话的比例保持稳定,不同阶段没有明显变化 (p = 0.39).
- 电话遭遇记录率略有改善,但没有达到统计学意义 (79%至87%,p = 0.21).
结论:
- 针对术后护理人员指示的有针对性的干预措施有效地减少了与术后护理相关的电话.
- 文档的标准化得到了实现,但总体呼叫量和非紧急呼叫的比例没有下降.
- 可能需要进一步的策略来解决非紧急呼叫量,并改善文档合规性.
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