吉捷快递:一个改进的倡议,以减少镇静和麻醉,用于胃肠道管道交换管道交换
Qianqian Ellie Cheng1, Jan Schriefer1,2,3, Tina Sosa1,2,3,4
1University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Pediatric research
|February 22, 2024
概括
通过质量改进倡议,儿科胃肠道管切换的镇静和麻醉使用量从77.8%显著下降到11.3%. 这种方法提高了患者安全,降低了成本,但没有对医院收入产生负面影响.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 提高质量 提高科学 提高质量
- 患者安全 患者安全
背景情况:
- 过度使用镇静剂和麻醉剂来切换胃管 (GJ) 会导致延迟,并发症,资源浪费和患者体验不佳.
- 该医院的目标是在两年内将关节管交换的镇静/麻醉使用率从78%降低到20%.
研究的目的:
- 为了减少平静和麻醉的使用在日常的儿科胃肠管交换过程中.
- 提高患者安全,降低与关节管手术相关的医疗保健费用.
主要方法:
- 一个跨学科的质量改进团队进行了追溯图表审查和前时间序列分析.
- 衡量的主要结果是接受静止或麻醉治疗的儿科患者的百分比,用于GJ管交换.
主要成果:
- 儿童用镇静或麻醉进行的GJ管交换的中位数百分比从77.8%降至11.3%.
- 统计过程控制 p-图表表明,随着时间的推移,持续减少.
- 大多数患者 (76%) 被医疗补助计划覆盖,降低麻醉医生的收费并没有对财务产生负面影响.
结论:
- 一项涉及患者,家属和儿科专业人员的跨专业倡议成功地减少了过度使用静止剂和麻醉剂的GJ管交换.
- 这种质量改进工作对于管理患有需要GJ管养问题的儿童的机构来说非常重要.
- 这项研究强调了有限文献的关键问题,为改善患者安全和降低成本提供了一个模型.
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