提高质量,减少高流量鼻腔管在患有支气管炎的儿童中过度使用
Jennifer D Treasure1,2, Matthew J Lipshaw2,3, Preston Dean2,3
1Division of Hospital Medicine.
Pediatrics
|August 11, 2023
概括
通过实施质量改善策略,在支气管炎患者中减少了高流量鼻腔管氧疗法 (HFNC) 的使用. 这一举措成功地减少了HFNC的使用量,并缩短了儿科患者的住院时间.
科学领域:
- 儿科 儿科 儿科
- 呼吸系统医学 呼吸系统医学
- 提高质量 提高质量
背景情况:
- 高流量鼻氧疗法 (HFNC) 广泛用于治疗儿童的支气管炎.
- 目前的证据表明,HFNC不能改善关键的临床结果,如停留时间或减少ICU入院.
- 需要优化HFNC在儿科支气管炎管理中的使用.
研究的目的:
- 降低因支气管炎住院的儿童使用HFNC的比例.
- 目标是在两年内将HFNC的使用率从41%降至20%.
- 为了提高儿童支气管炎的高价值,基于证据的护理的提供.
主要方法:
- 一个多学科团队采用了质量改进方法来标准化HFNC的使用.
- 关键干预措施包括标准化启动标准,员工教育,实时提供者反,家庭沟通脚本和团队聚集.
- 统计过程控制图表监测了HFNC的使用情况,数据与控制机构进行了比较.
主要成果:
- 在干预实施10个月内,HFNC用于支气管炎患者的使用量从41%降至22%.
- 这种HFNC使用量的减少持续了超过12个月.
- 患有支气管炎的儿童住宿的平均时间减少了25%,从60小时降至45小时.
结论:
- 质量改进计划成功减少了儿童支气管炎入院中的HFNC使用.
- 最优化的方法改善了提供高价值和基于证据的护理.
- 减少HFNC的使用与停留时间的显著减少有关.
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