赋予远程测量技术人员权力和加强沟通,以改善医院内心脏骤停生存率
Cody McCoy1, Neil Keshvani2, Maryam Warsi3
1Division of Cardiology, Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
BMJ open quality
|September 20, 2023
概括
实施捆绑干预显著提高了医院内心脏骤停 (IHCA) 的生存率,特别是对于心室高心率/心室动事件. 这种以沟通为中心的方法通过降低心脏骤停期间和之后的死亡风险来改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 医院内心脏骤停 (IHCA) 治疗的延迟会对患者的生存率产生负面影响.
- 集中式遥测监测对于早期发现心脏事件至关重要.
研究的目的:
- 评估一组干预措施的有效性,旨在提高通过集中遥测监测的患者的IHCA生存率.
- 评估加强沟通和快速响应激活对IHCA结果的影响.
主要方法:
- 一项追溯质量改进研究分析了75个IHCAs在四年内 (20个干预前,55个干预后).
- 捆绑的干预包括远程测量热线,技术人员直接激活IHCA响应团队,以及标准化关键警报系统.
- 考克斯比例危险回归被用于分析死亡风险.
主要成果:
- 捆绑干预与在代码期间死亡风险降低了74%,在出院前死亡风险降低了55%.
- 整体IHCA生存率从60.0%提高到了83.6% (p=0.031).
- 静脉动脉/静脉动 (VT/VF) 停止的存活率从50.0%显著提高到100.0% (p=0.035),而非遥测IHCA存活率没有变化.
结论:
- 一个捆绑的干预措施,增强通信和授权远程测量技术人员可以显著提高IHCA的生存率.
- 这项干预措施对经历VT/VF停止的患者显得特别有益.
- 优化沟通通路是改善住院患者关键心脏事件的关键.
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