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儿童手术后新生儿重症监护室减少非计划性输管:质量改进项目
Peter Juviler1, Jeffrey M Meyers2, Elizabeth Levatino1
1Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Journal of pediatric surgery
|October 16, 2023
概括
一项质量改善计划显著减少了新生儿重症监护室 (NICU) 的76%的无计划输管. 这一努力改善了患者的治疗结果,并降低了死亡率.
科学领域:
- 儿科手术 儿科手术
- 提高质量 提高科学 提高质量
- 新生儿重症监护中心
背景情况:
- 儿科手术后的无计划输管增加了死亡率.
- 新生儿重症监护室 (NICU) 被确定为这些事件的高偏差区域.
- 为了解决这一关键问题,启动了一项质量改进项目.
研究的目的:
- 在一年内将术后的无计划输管事件减少25%.
- 在NICU环境中实施有针对性的干预措施.
- 改善小儿手术后的患者安全和结果.
主要方法:
- 一个多学科团队根据案例审查开发了干预措施.
- 实施了输出的准备清单和非阿片类药物疼痛管理指南.
- 利用统计过程控制方法来进行前性跟踪和评估.
主要成果:
- 在新生儿重症监护室 (NICU) 实现了76%的无计划输管减少 (0.07对0.27事件/患者).
- 术后阿片类药物使用的显著减少,随着乙氨基的增加.
- 肺炎发病率或住院时间长度没有显著差异.
- 在NICU患者的30天死亡率显著下降 (0.7%对6.5%).
结论:
- 专注于阿片类药物管理和输管准备的质量改进工作有效地减少了NICU患者的意外输管.
- 这些干预措施提高了患者的安全性,降低了死亡率.
- 这项研究强调了针对性质量改善在儿科外科护理的成功.
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