通过使用质量改进方法来减少异形脊椎病患者手术后停留时间
Crystal Seilhamer1, Kelly Miller1, Jessica Holstine2
1From the Center for Comprehensive Spine Care, Department of Orthopedics, Nationwide Children's Hospital, Columbus, Ohio.
Pediatric quality & safety
|August 8, 2023
概括
这项质量改进倡议成功地减少了背脊融合的异常脊柱病患者住院时间 (LOS). 标准化护理途径和改善的疼痛管理显著降低了平均LOS,改善了患者的康复.
科学领域:
- 整形外科手术 整形外科手术
- 提高质量 提高质量
- 儿科医疗保健 儿科医疗保健
背景情况:
- 脊椎病影响1%-3%的美国人口,其中80%是异常脊椎病.
- 大约10%的异常脊柱病患者需要手术干预,特别是后脊柱融合.
- 这些患者的住院时间 (LOS) 超过同行机构,这表明需要改进.
研究的目的:
- 为了减少逗留时间 (LOS) 患者经历后脊髓融合的异常脊柱病.
- 在程序后4天内将放电率从39.13%提高到90%的目标.
主要方法:
- 实施新的疼痛管理协议.
- 引入为提供者和家庭提供每日以患者为中心的检查清单.
- 加强患者和家庭对术后疼痛预期的教育.
- 更新的电子订单集,以简化护理.
主要成果:
- 在4天内实现了93.48%的排放率,远远超过了90%的目标.
- 从4.93天降低了手术后的平均LOS,从2.59天降低到4.93天.
- 在术后第二天,患者控制止痛的患者比例从13%增加到97.75%,而不会影响重入院或治疗疼痛的ED访问.
结论:
- 一个标准化的护理途径,包括以患者为中心的检查清单和更新的疼痛管理,有效地减少了异常脊柱病患者的LOS.
- 建立了对LOS和疼痛管理的明确期望,从而改善了患者的治疗结果.
- 该计划成功地证明了对脊柱融合患者的术后护理管理的质量改善.
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