临床决策支持警报对新生儿重症监护病房知情同意文件的影响
Emily Sangillo1, Neena Jube-Desai1, Dina El-Metwally1
1From the Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md.
在新生儿重症监护室 (ICU) 改善知情同意至关重要. 一种包括临床决策支持 (CDS) 警报在内的捆绑方法,显著提高了同意文件的遵守率,从0%增加到86%以上.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者安全 患者安全
- 医学伦理 医学伦理
背景情况:
- 知情同意对于患者的自主权和共同决策至关重要.
- 在重症监护病房 (ICU) 中,同意文件的遵守通常是不理想的.
- 这项研究的重点是改善新生儿ICU中的捆绑同意文件.
研究的目的:
- 加强对新生儿ICU中的捆绑同意文件的遵守.
- 在一年内实现50%的合规率.
- 评估多方面的质量改进干预措施的影响.
主要方法:
- 利用计划-做-研究-行动 (PDSA) 模型进行质量改进.
- 实施的干预措施:教育,过程重新设计,表格修订和临床决策支持 (CDS) 警报.
- 每月进行审计,以追踪同意遵守情况,并收集关于CDS的反.
主要成果:
- 在37个月内,同意遵守的中位数从0%增加到86.6%.
- 引入CDS警报与最高的合规率 (93.3%) 有关.
- 在CDS恢复后,观察到持续的合规性,最后7个月没有缺失的表格.
结论:
- 一个多方面的战略,特别是CDS警报,显著改善了新生儿ICU的捆绑同意文档合规性.
- 这些发现表明,CDS干预可以有效地加强ICU的知情同意过程.
- 这种方法有可能改善重症监护机构的患者护理和自主权.
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