遵守血管护理指南,以紧急进行慢性肢体威胁性缺血症的重血管化
Toby P Speirs1,2, Eleanor Atkins1,3, Mohammed M Chowdhury1,4
1Department of Vascular Surgery, Cambridge University Hospitals, Queens' College, Cambridge, UK.
Journal of vascular surgery cases and innovative techniques
|December 15, 2023
概括
英国的英国.
科学领域:
- 血管外科和卫生服务研究研究
- 在医疗保健中的实施科学.
背景情况:
- 国家卫生服务质量和创新委员会 (CQUIN) 于2022年引入了血管外科手术的绩效支付指标,以激励慢性四肢威胁性缺血症 (CLTI) 的及时再血管化.
- 评估这种财政激励对临床途径和患者结果的影响对于改善对CLTI患者的护理至关重要.
研究的目的:
- 评估CQUIN指标对CLTI护理过程措施和患者结果的影响.
- 在CQUIN实施后,评估遵守外围动脉疾病质量改善框架 (PAD-QIF) 指南.
主要方法:
- 在一个区域血管中心进行了一项回顾性前后队列研究,比较了在CQUIN引入之前和之后入院的CLTI患者.
- 分析了关键的过程措施,包括重血管化的时间和遵守PAD-QIF目标.
- 两个队列之间比较了患者的结局,如并发症,停留时间和死亡率.
主要成果:
- 在CQUIN后的5天目标时间内接受重血管化的患者的百分比显著增加,从41.2%增加到58.8% (P=.049).
- 在转诊至入院和入院至专家审查时间方面,有所改善,但并非所有情况都达到统计学意义.
- 没有观察到患者结局 (并发症,停留时间,死亡率) 的统计学意义上的变化,其他指南目标的文档很差.
结论:
- 根据CQUIN的绩效支付指标,似乎已经增加了对CLTI及时再血管化和改进的流程措施的关注.
- 需要进一步收集数据,以确定对患者结果的任何影响.
- 改善护理指南遵守的文件是必不可少的.
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