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实施质量管理策略提高了临床质量,因为纳米比亚的自愿医疗男性割礼计划成熟了:一个过程分析

Gillian O'Bryan^1,2, Alison Ensminger^3,4, Idel Billah⁵

¹International Training and Education Center for Health (I-TECH), Seattle, WA, USA. gilliano@uw.edu.

BMC health services research

|September 29, 2023

概括

在纳米比亚,随着计划的成熟,自愿医疗男性割礼 (VMMC) 计划的质量管理显著减少了不良事件 (AE). 持续的质量改进工作对于安全的VMMC扩展至关重要.

科学领域:

公共卫生公共卫生
改善外科手术的质量
预防艾滋病毒预防艾滋病毒

背景情况:

手术自愿医疗男性割礼 (VMMC) 是一种关键的艾滋病毒预防策略,但在扩大期间保持质量存在挑战.
持续的质量管理 (QM) 对于确保患者安全和计划有效性至关重要.
本研究侧重于2015年1月至2019年9月在纳米比亚实施VMMC.

研究的目的:

通过测量VMMC实施四年的不良事件 (AE) 率来描述程序质量.
为了比较随时间推移的AE率,并分析质量管理流程的影响.
为了说明随着VMMC计划的成熟,临床质量的改善.

主要方法:

多学科团队在技术支持下实施了一套全面的质量管理策略.
从VMMC注册,客户表格和AE报告中收集了回顾性数据.
随着时间的推移,经历AE的客户比例使用Cochran-Armitage趋势测试进行了分析.

主要成果:

总共进行了40336次VMMC手术,其中593名 (1.5%) 的客户经历了手术后的AEs.
在每个地区,AE率在服务提供的初始阶段是最高的.
随着计划的成熟,在实施期间观察到AE率的显著下降 (p < 0.001).

结论:

随着VMMC计划的成熟,质量管理措施的实施和常规化导致临床质量的显著改善.
系统和持续的质量管理流程,适应当地环境,提高VMMC服务的临床安全.
从成熟的项目网站中建立的质量管理实践可以迅速采用,在项目扩展期间解决质量问题.

关键词:

不良事件不良事件不良事件预防艾滋病毒预防艾滋病毒纳米比亚纳米比亚纳米比亚纳米比亚质量质量质量质量质量质量质量质量.自愿医疗男性割礼 (VMMC) 是一种医疗的方法.

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