护士专注于超声波导向的静脉注射程序改善了急诊室的核心过程措施
Ross Kessler1, Jane Hall1, Anne K Chipman1
1Department of Emergency Medicine, University of Washington, Seattle, WA, USA.
The journal of vascular access
|February 19, 2024
概括
在难以进入静脉的患者 (DIVA) 中,超声导向的外周IV导管 (USGIV) 插入的质量改进计划使USGIV使用翻了一番. 这一举措还改善了急诊室的关键流程措施,提高了患者护理质量.
科学领域:
- 紧急医疗 紧急医疗
- 提高质量 提高质量
- 血管接入 血管接入
背景情况:
- 难以静脉注射 (DIVA) 在急诊室 (ED) 是常见的.
- 超声导向的外周IV导管 (USGIV) 插入是一种有效的方法,可以在DIVA患者中建立血管接入.
- 制定了一项质量改进计划,以解决DIVA和促进USGIV.
研究的目的:
- 描述一个DIVA质量改进计划,重点是快速识别和紧急护士USGIV培训.
- 评估该计划对USGIV使用频率的影响.
- 评估该计划对与患者护理质量相关的流程措施的影响.
主要方法:
- 从2018年9月到2020年9月,对成年患者进行了回顾性队列研究.
- 差异分析分析以比较ED过程措施的项目实施前和后.
- 多变量逻辑回归用于识别与难以入口IV接入相关的因素.
主要成果:
- 计划实施后,USGIV安置频率翻了一番以上 (606次到1323次).
- 在对共变量调整的ED过程测量中观察到显著的改善,包括缩短CT与对比度的时间,止痛药的使用,静脉注射抗生素和整体ED停留时间.
- 具体时间缩短:CT (4.8小时至4.1小时),止痛药 (2.4小时至1.8小时),静脉注射抗生素 (3.0小时至2.1小时) 和ED LOS (6.4小时至6.0小时).
结论:
- 一个以护士为中心的质量改进计划,促进USGIV用于DIVA,与USGIV利用率的增加有关.
- 该计划导致核心ED过程措施的改进,表明患者护理质量得到提高.
- 通过USGIV的培训和实施,可以有效地管理DIVA并优化ED的工作流程.
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