通过全医院干预增加静脉血栓塞栓症风险评估:服务前后评估,以证明质量改善
Juliana Abboud1,2, Niaz Shaikh2, Musthafa Moosa2
1Centre for Improving Health Related Quality of Life, School of Psychology, Queens University Belfast, David Keir Building, 18-30 Malone Road, Belfast BT9 5BN, United Kingdom.
概括
一个质量改进项目显著增加了入院患者静脉血栓栓塞 (VTE) 风险评估文档. 虽然VTE发病率略有下降,但主要影响是改善风险评估遵守,而不是统计学上显著减少VTE事件.
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
- 临床风险管理临床风险管理
背景情况:
- 静脉血栓塞栓症 (VTE) 是与医院相关的发病率和死亡率的主要原因.
- 一致的VTE风险评估对于预防至关重要,但经常不一致地执行.
- 这项研究解决了在急性护理机构改善VTE风险评估文档的需求.
研究的目的:
- 评估质量改进 (QI) 项目的对VTE风险评估文档率的影响.
- 为了确定QI干预是否通过影响VTE发病率而影响患者安全.
- 评估改进的VTE风险评估实践的可持续性.
主要方法:
- 基于FOCUS PDCA方法的多组件QI干预措施在三个月内实施.
- 干预措施包括教育,合规反,提醒,联络医生和指南更新.
- 干预前后的研究设计比较了VTE风险评估文档和17,612名成年患者的发病率.
主要成果:
- 静脉瘤风险评估的文档从干预前的42%显著增加到干预后的60% (P < 0.001).
- 在实施后的15个月内,文档的改进持续了15个月.
- 观察到VTE发病率略有,但不具有统计学意义的下降 (0.5%至0.4%,P<0.397).
结论:
- 质量改进项目成功提高了住院患者VTE风险评估的文档.
- 虽然VTE发病率没有显著下降,但该项目改善了对VTE预防指南的遵守.
- 风险评估文档的持续改进表明,QI干预措施在改变实践方面是有效的.
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