出院后的阿片类药物处方在剖腹产后:质量改善倡议
Katherine T Pellino1, Alexandra Kershner1, Erika L Peterson1
1Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin.
American journal of perinatology
|October 3, 2023
概括
在剖腹产后实施阿片类药物处方算法减少了处方阿片类药物的数量,而不会增加与疼痛有关的问题. 这种方法确保了适当的疼痛管理,并减少了剩余的药物.
科学领域:
- 产科和妇科 产科和妇科
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 剖腹产后过度处方阿片类药物是一个重大问题,导致未使用的药物.
- 以前的研究表明,基于住院患者使用的个性化阿片类药物处方可能是有效的.
研究的目的:
- 评估一个用户友好的算法是否可以在出院时进行个性化阿片类药物处方,从而减少剖腹产后的阿片类药物数量.
- 评估这个算法的影响与疼痛相关的遭遇和退院后的额外处方.
主要方法:
- 一项质量改善计划实施了一种阿片类药物释放的算法,规定了剖腹产后的药物.
- 根据住院患者的阿片类药物需求,患者被分为不同类别,以指导出院处方.
- 在干预组 (n=382) 和对照组 (n=391) 之间进行了回顾性比较.
主要成果:
- 干预组在出院时接受的氧化片数量显著减少 (11.1 vs 15.8,p < 0.001).
- 在分娩后6周内,没有观察到与疼痛相关的遭遇 (10.5%与10.3%) 或额外的阿片类药物处方 (4.7%与4.3%) 的显著差异.
结论:
- 在剖腹产后,基于算法的阿片类药物处方方法有效地减少了处方数量.
- 这种方法可以减少阿片类药物浪费,而不会影响患者的疼痛管理或增加不良事件.
- 一个简单,可重复的算法可以改善处方者遵守和优化阿片类药物使用.
相关概念视频
01:31Discharge Summary Forms
776
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
776
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
326
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
326
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
106
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
106
01:29Appendicitis-II: Diagnostic Studies and Management
91
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
91
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
15
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
15