改善儿童瘤学患者新发烧的抗生素治疗时间
Wesley T Smith1, Jay Read2, Shreya Agarwal3
1Department of Pediatrics, Division of Hematology/Oncology, University of Kentucky College of Medicine, Kentucky Children's Hospital, Lexington, KY.
JCO oncology practice
|February 14, 2024
概括
实施多学科方法显著改善了中性衰竭发烧的儿科瘤患者的抗生素给药时间,将其从89分钟减少到46.4分钟.
科学领域:
- 儿科瘤学 儿科瘤学
- 提高质量 提高科学 提高质量
- 传染病管理 传染病管理
背景情况:
- 及时服用抗生素 (TAA) 对患有中性衰竭发烧的儿科瘤患者至关重要,影响了败血症和ICU入院率.
- 国家质量指标强调TAA在60分钟内为这个弱势群体.
- 之前的基线评估显示,只有19%的患者在目标时间内接受了抗生素.
研究的目的:
- 实施和评估一项多学科干预措施,以增加儿科瘤患者在出现新发烧后60分钟内接受抗生素的百分比.
- 提高护理质量,减少延迟抗生素的不良结果.
主要方法:
- 一个多学科的团队利用了四个计划-做-研究-行动 (PDSA) 周期超过18个月 (2021年3月-2023年9月).
- 干预措施包括有针对性的教育,更新的交付流程,抗生素冠军 (AC) 护理角色,快速反应团队和简化血液培养收集算法.
- 关于TAA的数据被收集,分析并每两周报告一次,并对延迟进行反机制.
主要成果:
- 平均TAA从基线89分钟显著下降到46.4分钟.
- 在60分钟内接受抗生素的患者比例从19%增加到93.7%,持续改善.
- 最具影响力的干预措施是建立AC作用和优化血液培养采集过程.
结论:
- 为了在儿科瘤学中实现最佳的患者护理,多学科合作至关重要.
- 有针对性的干预措施,包括教育,AC的作用和简化流程,导致TAA的显著改善.
- 进一步的研究将调查这些干预措施对患者结果的影响.
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