一个快速改善的事件:孕激素处方预防流产
Lucy Anne Bolger1, Nicola O'Riordan2, Cathy Allen2
1Obstetrics & Gynaecology, National Maternity Hospital, Dublin, Ireland lucybolger1994@gmail.com.
BMJ open quality
|March 26, 2024
概括
一个快速改善事件 (RIE) 成功增加了48%的孕处方,用于早期怀孕出血. 这一举措增强了临床医生的信心和遵守更新的流产治疗指南.
科学领域:
- 产科和妇科 产科和妇科
- 临床过程改进 临床过程改进
- 基于证据的医学基于证据的医学.
背景情况:
- 更新的NICE指南 (2021年11月) 建议孕激素用于威胁流产,基于柯克兰元分析和PRISM试验.
- 这些研究表明,在怀孕早期出血时,使用阴道微化孕激素的活产率更高.
- 最初的审计显示,研究单位的孕激素处方率低于最佳水平.
研究的目的:
- 实施和评估快速改善事件 (RIE),以增加孕激素的处方,用于早期妊娠出血.
- 为了解决员工对新孕激素处方指南的知识和信心不足的问题.
- 改善对威胁流产的基于证据的治疗的坚持.
主要方法:
- 一个多学科的团队使用了RIE框架来分析和改进孕激素处方过程.
- 教育干预包括在医院的大轮演讲和传播信息图表.
- 干预前后进行了审计,以评估处方率和工作人员的信心.
主要成果:
- 干预后,孕激素处方率提高了48%.
- 临床医生对按照新指南处方的信心和舒适度从43%增加到78%.
- RIE在改善临床实践和遵守指南方面表现出有效性.
结论:
- 快速改善事件是有效的增强临床过程和改善患者护理.
- 有针对性的教育和明确的指导方针传播可以克服基于证据的实践采用的障碍.
- 这种方法促进了合作,并有效地实施了威胁流产的更新治疗方案.
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