在伦敦一家教学医院改善治疗升级计划 (TEP) 的完成率:质量改善研究
Saphalya Pattnaik1, Ahmadreza Zarifian1, Gur Aziz Singh Sidhu2
1Trauma and Orthopaedics, University Hospital Lewisham, London, GBR.
Cureus
|December 27, 2023
概括
实施治疗升级计划 (TEP) 可以改善患者的护理决策. 在骨科病房引入局部途径和算法后,员工对完成TEP的坚持显著增加.
科学领域:
- 医疗管理医疗管理
- 改善医疗保健质量 改善医疗保健质量
- 患者安全 患者安全
背景情况:
- 治疗升级计划 (TEP) 对于在管理病情恶化的患者,定义护理限制方面做出明确决策至关重要.
- 这些计划包括与患者或亲属进行讨论,以达成对护理的共同协议.
- 研究的重点是改善员工在骨科病房入院时遵守TEP完成的情况.
研究的目的:
- 加强工作人员对成年骨科住院患者完成治疗升级计划 (TEP) 的坚持.
- 评估干预措施在提高TEP完成率方面的有效性.
- 为了减少患者入院时不完整的TEP的发生率.
主要方法:
- 一个计划-做-学习-行动 (PDSA) 方法在伦敦一家教学医院被使用.
- 对骨科病房的成年住院患者进行了横截面审计.
- 干预措施,包括内部算法和部门会议,在两个研究周期之间实施.
主要成果:
- 没有完整的TEP患者的比例从第一周期的30.4%下降到第二周期的11.76%.
- 在两个PDSA周期中,共抽取了50名患者的样本 (n=27在周期1,n=23在周期2).
- 实施一个指定的本地TEP路径导致了更好的坚持.
结论:
- 机构算法和部门会议是改善员工遵守TEP完成的有效干预措施.
- 持续的培训和教育对于消除障碍和维持TEP完成率至关重要.
- 这项研究表明,骨科患者护理规划的质量改善倡议取得了成功.
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