减少患有支气管炎的儿童过度使用高流量鼻
Diana Jo1, Nisha Gupta1,2, David Bastawrous1
1From the Department of Pediatrics, Inova Children's Hospital, Falls Church, Va.
Pediatric quality & safety
|October 11, 2023
概括
一个新的协议成功地减少了高流量鼻腔管 (HFNC) 在患有支气管炎的住院儿童的使用. 这种干预措施还缩短了住院时间和氧气需求,但没有影响重症监护转移或再入院.
科学领域:
- 儿科呼吸系统医学 儿科呼吸系统医学
- 改善医疗保健质量 改善医疗保健质量
- 临床干预研究临床干预研究
背景情况:
- 支气管炎是儿童住院的主要原因.
- 高流量鼻腔管 (HFNC) 在支气管炎中的使用往往过度,导致成本增加和ICU利用.
- 目前的证据表明,HFNC不会显著改善支气管炎的临床结果.
研究的目的:
- 在被诊断患有支气管炎的住院儿童中减少HFNC的发病率.
- 目标是在六个月内减少HFNC使用的20个百分点.
- 评估新的HFNC启动协议的安全性和影响.
主要方法:
- 实施HFNC启动的协议,包括呼吸得分系统和多学科团队聚集.
- 支持措施包括员工教育,EHR整合和审计/反.
- 统计过程控制图表监测了关键指标,如HFNC使用率和停留时间.
主要成果:
- 在协议实施的一个月内,HFNC的使用率从82%下降到60%.
- 住宿时间的中位数从54小时减少到42小时.
- 补充氧气的中位时间从50小时减少到38小时;在ICU转移或再访中没有显著变化.
结论:
- 一个结构化的HFNC启动协议可以有效地减少其在儿科支气管炎住院治疗中的过度使用.
- 该协议证明了HFNC利用率的安全降低.
- 干预导致了资源利用的显著改善,包括更短的停留时间和氧气使用.
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