在心脏手术后提升早期的功能独立性:质量改进计划
Prasobh Jacob1, Praveen Jayaprabha Surendran2, Poonam Gupta3
1Cardiac Rehabilitation Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar physioprasobh@gmail.com.
BMJ open quality
|November 6, 2023
概括
早期流动性计划显著改善了心脏手术后患者的康复. 更多的患者在手术后实现了高功能独立性得分和增加了步行距离.
科学领域:
- 心脏病学 心脏病学
- 康复医学 康复医学 康复医学
- 提高质量 提高科学 提高质量
背景情况:
- 早期的运动和活动计划对于心脏手术后的康复至关重要.
- 基线数据显示功能独立性低 (5.3%通过POD3达到≥80%的FIM得分) 和步行距离有限 (188m通过POD4).
研究的目的:
- 实施质量改进项目,旨在使>80%的心脏手术患者在第三次术后日 (POD) 达到80%的功能独立测量 (FIM) 得分.
主要方法:
- 为了持续改进,采用了改进模式框架.
- 在干预前和干预后 (2021年2月实施) 收集数据.
- 统计分析包括控制图表,未配对的学生t测试和千平方测试.
主要成果:
- 患者的功能独立性显著改善,91.4%的患者通过POD 3获得≥80%的FIM得分,在实施后持续.
- 平均FIM分数在POD3时增加到81.20±3.77 (p<0.001).
- 平均6分钟的步行距离通过POD4提高到267.90±36.10米 (p<0.001).
- 患者对独立执行日常生活活动的信心增加到POD 5 (p<0.001) 的89.4% (p<0.001).
结论:
- 质量改进项目成功提高了心脏手术后的功能独立性,步行距离和患者信心.
- 实施的早期流动性计划是安全的,没有报告的不良事件.
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