遵守质量指标和最佳实践在巴雷特食道监视内镜:一个基于视频的评估评估
Thomas Enke1, Rajesh Keswani2, Joseph Triggs3
1Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, United States.
Endoscopy international open
|January 22, 2024
概括
对巴雷特食道的内镜监测显示,对质量指标和最佳实践的遵守程度较低. 视频审查揭示了记录的程序和实际事件之间的显著差异,影响了患者护理质量.
科学领域:
- 胃肠病学 胃肠病学
- 改善医疗质量 改善医疗质量
背景情况:
- 遵守巴雷特食道内镜监测的质量指标 (QI) 和最佳实践 (BP) 对于患者的结果至关重要.
- 临床文档往往不准确地反映了在B.E.内镜监测期间执行的实际程序.
研究的目的:
- 通过视频评估评估对BE内镜监测的可测量QI和BP的遵守情况.
- 识别记录实践与实际程序事件之间的差异.
主要方法:
- 在2018年3月至2020年10月期间进行的138次BE (≥1厘米) 监视内镜的回顾性视频审查.
- 五位胃肠病学家对QI和BP的坚持进行了评估,评估了interrater变异性.
- 通用线性回归用于识别坚持的预测因素.
主要成果:
- 在视频审查中,使用虚拟染色内镜 (VC) 的检查发生在54%的病例中,只有67%的病例得到了记录.
- 在54%的案例中通过视频审查观察到遵守西雅图协议 (SP),但只有38%的案例得到了记录.
- 观察到差异,VC或SP使用记录但未观察到的情况分别为12%和22%.
结论:
- 视频评估证实在BE内镜监测中对QI和BP的遵守程度较低,验证了之前的发现.
- 临床文档与实际程序事件之间存在重大差异,突出需要提高监督和准确性.
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