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在儿科急诊室减少输液后镇静的时间

Claci Ayers¹, David P Johnson², Lacey Noffsinger¹

¹Division of Pediatric Emergency Medicine.

|March 27, 2024

概括

实施质量改善协议显著减少了在儿科急诊室启动输液后镇静 (PIS) 的时间,提高了患者的安全性,并防止了无计划的输液.

科学领域:

儿科急救医学儿科急救医学
提高质量提高科学提高质量
患者安全患者安全

背景情况:

不充分的输液后镇静 (PIS) 与诸如无计划的输液拔出等不良事件有关.
一个儿科急诊室观察到,只有约25%的儿童得到了及时的PIS,其中有2次内管脱.
现有的PIS平均时间为39分钟.

研究的目的:

将PIS启动的平均时间从39分钟缩短到15分钟以下.
改善儿科急诊部的患者护理和安全.
要在2021年9月之前实现这一目标.

主要方法:

一个多学科团队使用关键驱动图开发了一个标准化的PIS协议.
计划-做-研究-行动循环指导干预,包括教育和检查清单的开发.
数据使用X-bar和S图表进行分析,测量到PIS的时间和计划外抽.

主要成果:

最初的协议实施将PIS的平均时间从39分钟减少到21分钟.
进一步的干预导致9个月的PIS持续平均时间为13分钟.
干预后没有观察到与PIS相关的低血压或计划外抽的发作.

结论:

质量改进方法有效地减少了儿科紧急情况中PIS启动时间.
该研究表明,通过标准化镇静实践,患者安全得到了持续改善.
这种方法成功地将与不充分的输液后镇静相关的关键不良事件降到最低.

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