通过实施晚期早产婴儿养方案来减少手术疼痛和避免外围静脉导管:质量改进项目
Jennifer Hanford1, Christine McQuay, Akshaya Vachharajani
1Neonatal Intensive Care Unit, University of Missouri Healthcare, Women's Hospital, Columbia.
概括
对晚期早产婴儿实施新的养方案显著降低了静脉注射 (IV) 接入和初始亲肠营养 (PN) 的需求,减少了婴儿的疼痛. 这种方法优化了这个弱势群体的营养.
科学领域:
- 新生儿医学 新生儿医学
- 儿童营养学 儿童营养学
- 提高质量 提高科学 提高质量
背景情况:
- 晚期早产代表了所有早产的很大一部分.
- 晚期早产婴儿的最佳营养策略和肠道养方法尚未确立,往往导致依赖静脉注射 (IV) 液体.
- 目前的做法可能涉及不必要的静脉输入和初始亲肠道营养 (PN).
研究的目的:
- 创建和实施晚期早产婴儿的食方案.
- 主要目标是减少对IV接入的要求,尽量减少初始PN的使用,并减轻新生儿重症监护室 (NICU) 婴儿的疼痛.
- 为了提高晚期早产婴儿的护理和结果.
主要方法:
- 计划-做-研究-行为 (PDSA) 质量改进模型作为框架.
- 一项全面的文献审查为制定一个养方案提供了信息,强调明智的初始PN使用.
- 该协议被实施,评估和完善,包括添加电子医疗记录自动文本提醒.
主要成果:
- 协议的实施导致了外围IV接入的显著减少,从70%降至42% (P = .0017).
- 启动PN的启动率大幅下降,从55%降至7% (P < .00001).
- 这些减少在没有对其他临床措施产生重大不良影响的情况下实现,婴儿疼痛减少.
结论:
- 在稳定,晚期早产婴儿入院时开始肠道食是一种有效的策略.
- 这种方法成功地减少了对外围IV接入的需求.
- 因此,该协议的实施减少了婴儿的手术疼痛.
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