实现全球外科卓越:基于证据的框架,指导低收入和中等收入国家的外科质量改进计划
Jaymie Claire Henry1, Lye-Yeng Wong2, Ana M Reyes3
1Department of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX, United States.
这项研究提供了基于证据的建议,以改善低收入和中等收入国家 (LMICs) 的外科护理. 它提供了一个质量改善和资源配置的框架,以加强全球外科手术服务.
科学领域:
- 全球健康 全球健康
- 改善外科手术的质量
- 加强卫生系统 加强卫生系统
背景情况:
- 缺乏基于证据的指导方针阻碍了全球外科手术护理的提供.
- 低收入和中等收入国家 (LMICs) 在提供外科手术服务方面面临重大挑战.
- 迫切需要实用,具有成本效益的解决方案来改善LMIC的外科治疗结果.
研究的目的:
- 制定一个推框架,以加强外科手术质量改善和扩大LMICs的举措.
- 总结最好水平的证据,用于减少LMICs的发病率和死亡率的过程.
- 建立国际专家的共识,以最佳组织的手术服务在LMICs.
主要方法:
- 对LMIC环境的文献综述和现有证据的综合.
- 应用GRADE方法论来确定证据和建议的强度.
- 修改的Delphi方法论,以达成国际专家的共识,对外科服务组织.
主要成果:
- 为减少手术部位感染,改善创伤系统和降低孕产妇/产周死亡率制定了建议.
- 分析支持针对手术部位感染 (27 项研究),创伤系统 (27 项研究) 和孕产妇/产前死亡率 (14 项研究) 的干预措施.
- 专家的共识优先考虑了地区医院的发展,以实现低复杂性,高体积的条件,并将紧急/必需的外科护理纳入全民健康覆盖.
结论:
- 该项目通过提供基于证据的,实用的和具有成本效益的解决方案来解决全球外科手术的关键差距.
- 这些建议是有效规划和资源分配的指南,用于在LMIC中提供高质量和安全的基本手术服务.
- 这些发现将支持在资源有限的环境中扩大外科护理计划.
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