通过全球触发器工具识别的触发器和患者伤害的患病率在专业化息治疗中
Olav Magnus S Fredheim1,2, Espen Klingenberg1, Anne Karin Lindahl2,3
1Department of Palliative Medicine, Division of Surgery, Akershus University Hospital, Lørenskog, Norway.
全球触发工具 (GTT) 在识别息治疗中的患者伤害方面表现不佳. 特定的触发因素可能有助于检测不合格的护理,特别是与过度治疗有关的护理.
科学领域:
- 抚慰性护理医学 抚慰性护理医学
- 患者安全 患者安全
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 全球触发工具 (GTT) 用于识别患者的危害.
- 它在息治疗中的表现,在那里预计会恶化,没有得到充分的记录.
- 这项研究探讨了确定了"伤害患者"的病例是否表明了改善患者安全的机会.
研究的目的:
- 评估GTT在息治疗患者的性能和适用性.
- 试点特定的触发器,以识别不符合标准的息治疗.
主要方法:
- 在GTT被应用到113连续的息治疗患者.
- 分析了确定的患者伤害病例,以区分疾病轨迹和治疗后果.
- 试行了不符合标准的息治疗的触发因素.
主要成果:
- 确定了212个触发因素和26个患者伤害病例 (1.9个触发因素/住院).
- 患者损害的积极预测值 (PPV) 很低 (0.12). 压力是最常见的伤害.
- 在26个伤害病例中,6个与疾病有关,10个是治疗后果. 使用试点触发器确定了9例不符合标准的护理,最高的PPV (0.67) 为"在死亡前不到5天停止使用抗生素".
结论:
- 除了压力外,GTT触发器在息治疗中对患者伤害的PPV较低.
- 针对过度治疗的触发器显示出潜在的潜力,用于识别不合格的息护理.
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