在儿科内镜检查之前实施出血风险查工具和血液学转诊过程
Brianna McSorley1, Ankur Chugh1, Tea Abazi1
1From the Division of Pediatric Gastroenterology, Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee, WI.
Journal of pediatric gastroenterology and nutrition
|August 23, 2023
概括
胃肠道内镜的新出血风险查工具改善了供应商的合规性,并减少了血液学转诊的等待时间. 这一过程确定了新的出血障碍,预防了儿科患者的并发症.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 血液学 血液学 血液学
- 质量改进项目 质量改进项目
背景情况:
- 胃肠道 (GI) 内镜手术具有较低的出血风险 (0.11%).
- 缺乏一种标准化的方法,用于在内镜检查之前识别高风险患者.
- 接受内镜检查的儿科患者可能有未被诊断的出血风险.
研究的目的:
- 实施和评估用于儿科内镜的修改出血风险查工具.
- 改进对患有出血并发症风险的患者的鉴定.
- 评估对血液学转诊和诊断率的影响.
主要方法:
- 适应了经过验证的,基于病史的出血风险查工具,用于内镜前的使用.
- 实施了血液学转诊过程,以检测阳性查.
- 评估提供者合规性,转诊率,血液学预约时间,新诊断和2019-2021年的出血并发症.
主要成果:
- 提供者对出血查的遵守率从48%增加到75%.
- 血液学预约的时间从30天减少到7.5天.
- 22%的查阳性患者被诊断出患有新的出血障碍;没有出血并发症.
结论:
- 一个标准化,基于病史的查工具有效地识别出患有出血风险的儿科患者.
- 实施的过程改善了查合规性和及时的血液学评估.
- 基于查的预防措施确定了未被诊断的出血障碍,避免了手术并发症.
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