制定患者安全措施,以识别常见感染的不适当诊断
Andrea T White1, Valerie M Vaughn1,2,3, Lindsay A Petty4
1Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
概括
新的安全措施准确地识别住院患者的尿路感染 (UTI) 和社区获得性肺炎 (CAP) 的不适当诊断,从而减少诊断错误和改善护理.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 内部医学中的诊断准确性
- 医院环境中的患者安全.
背景情况:
- 感染的不适当诊断导致过度使用抗生素,并导致识别潜在疾病的延迟.
- 尿路感染 (UTI) 和社区获得性肺炎 (CAP) 是常见的住院感染,经常存在诊断错误.
- 制定准确的诊断安全措施对于改善住院护理至关重要.
研究的目的:
- 开发和描述两种针对尿路感染和CAP不适当诊断的安全措施.
- 评估这些诊断措施的可靠性,有效性,可行性和可用性.
- 为医院提供工具,以提高诊断安全性和优化抗生素使用.
主要方法:
- 使用临床指南,文献和来自密歇根州49家医院的数据,制定了措施.
- 调整和完善涉及最终用户,技术专家小组和患者重点小组的投入.
- 严格评估了可靠性,有效性 (包括面部有效性和隐性案例审查) 和可行性.
主要成果:
- 制定了两个国家质量论坛 (NQF) 认可的针对尿路感染和CAP不适当诊断的措施.
- 证明了出色的可靠性 (0.90对于UTI,0.91对于CAP) 和强大的有效性.
- 密歇根州医院的实施 (2017-2020年) 显示,不适当的诊断显著减少 (37%的尿路感染,32%的CAP).
结论:
- 对住院患者不适当的尿路感染和CAP诊断已开发出高度可靠,有效和可用的措施.
- 这些措施可以显著提高诊断安全性,减少不必要的抗生素处方.
- 医院应该采取这些措施来加强患者护理和优化感染管理.
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