简单的标牌和有针对性的教育可以导致急性尾炎护理过程的改善
Rex Atwood1, Patrick Benoit2, William Hennrikus2
1Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA rex.e.atwood.mil@health.mil.
BMJ open quality
|October 25, 2023
概括
有针对性的教育和可见标志显著改善了在诊断成像和抗生素使用中对急性尾炎协议的遵守,提高了患者护理和医院效率.
科学领域:
- 改善医疗质量 改善医疗质量
- 外科手术的协议.
- 医疗保健管理的管理
背景情况:
- 实施了急性尾炎的全机构协议,以在急诊部,放射科和外科手术中标准化最佳实践.
- 使用智能手机应用程序和领导沟通的初始实施导致对诊断成像和抗菌药物管理指南的遵守不足.
- 不良的遵守需要进一步干预,以改善协议的遵守.
研究的目的:
- 评估面对面的有针对性的教育和可见标牌在改善对急性尾炎协议的遵守方面的有效性.
- 提高急性尾炎患者的放射诊断和抗菌药物管理的效率.
- 确定简单,有效的干预措施,以提高急性手术环境中的护理质量.
主要方法:
- 外科住院医生接受了针对性面对面的教育,对方案特定的抗生素选择和诊断成像进行了针对性教育.
- 在紧急情况和放射学工作区域放置了突出显示首选成像和抗生素选择的可见标志.
- 在每次干预之前和之后,对诊断成像和抗微生物药物管理的协议遵守率进行了比较.
主要成果:
- 有针对性的教育将抗生素管理的遵守率从30%提高到91% (p<0.005).
- 可见标志改善了急诊室的加速抗微生物药物管理,从50%提高到90% (p<0.005).
- 在放置标志后,诊断成像粘附率从35%增加到75% (p<0.005).
结论:
- 智能手机应用程序和领导沟通单独不足以实现最佳的协议遵守.
- 有针对性的教育和可见标志是有效的干预措施,可以显著改善对急性护理方案的遵守.
- 这些简单的,有针对性的干预措施可以应用于一般外科的其他领域,以提高质量和效率.
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