通过增加急诊室的尿液检测来改善低血症的管理
Nathaniel E Wiest1, Ayan Nasir2, Albert Bui2
1Internal Medicine, Mayo Clinic in Florida, Jacksonville, Florida, USA.
BMJ open quality
|September 27, 2023
概括
在急诊室 (ED) 治疗低血症 (低) 治疗前收集尿液研究随着质量改善举措显著改善. 这些干预措施确保了及时诊断和适当的患者护理.
科学领域:
- 内部医学 内部医学
- 提高质量 提高质量
- 紧急医疗 紧急医疗
背景情况:
- 住院时的低血与不良结果相关,包括更长的住院时间,成本增加和更高的死亡率.
- 及时诊断低血症对于有效治疗至关重要,需要在液体或利尿剂注射之前进行早期尿检.
研究的目的:
- 为了提高在急诊室 (ED) 接受中度至重度低血症患者的流体或利尿剂给药前尿样采集的速度.
- 实施和评估质量改进 (QI) 战略,以改善低血症的诊断实践.
主要方法:
- 由内科医生领导的多学科QI团队从2020年7月到2021年6月进行了一项项目.
- 采用了两个计划-做-研究-行动 (PDSA) 周期:第1周期涉及教育海报和工作人员会议;第2周期引入了对预标记尿液容器的护理分类的结构性变化.
主要成果:
- 在PDSA循环#1之后,尿样采集率从34.5%增加到57.5%.
- PDSA周期#2进一步提高了收集率,达到59%.
结论:
- 教育干预和结构过程变化的结合方法有效地提高了尿样采集率.
- 这些QI努力有助于在ED环境中迅速诊断和适当管理低血症.
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