在手术患者中实施Caprini风险评估模型 (RAM),以减少术后静脉血栓栓塞和在医院出院时处方埃诺沙巴林
Hope Walden1, Eleanor Stevenson2, Allen Cadavero2
1Nuvance Health - Danbury Hospital, 95 Locust Avenue, Danbury, CT 06810, USA.
概括
实施Caprini风险评估模型 (RAM) 改善了手术患者的VTE风险评分和抗凝药处方. 这项质量改善计划显示,与医院相关的VTE发生率下降,与国家基准保持一致.
科学领域:
- 医学科学 医学科学 医学科学
- 手术并发症 手术并发症
- 公共卫生 公共卫生
背景情况:
- 与医院相关的静脉血栓塞栓症 (VTE),包括深静脉血栓症 (DVT) 和肺栓塞 (PE),是可预防的医院死亡的重要原因.
- 手术后静脉动脉瘤通常发生在医院出院后,与最近的手术或住院有关.
- 医生之间VTE化疗预防处方的变化导致项目机构的手术后VTE高率.
研究的目的:
- 实施Caprini风险评估模型 (RAM) 作为手术患者的标准化工具.
- 评估Caprini RAM在减少术后静脉瘤并发症方面的有效性.
- 评估卡普里尼RAM对医生处方埃诺沙巴林在出院时进行VTE化疗预防的影响.
主要方法:
- 实施了一项使用计划-做-研究-行动 (PDSA) 周期的质量改进 (QI) 项目.
- 卡普里尼RAM用于术前和术后风险评估.
- 监测了医生对VTE化疗预防 (素) 的处方模式.
主要成果:
- 术前风险评估得分从基线的0%显著增加到26.3% (PDSA周期1) 和42.9% (PDSA周期2).
- 适当的抗凝药处方率显示出改善,从基线的12.5%上升到PDSA周期2的33.3%.
- 该机构的VTE发生率从1.02% (2021) 降至0.92% (2022),自2018年以来首次低于国家基准.
结论:
- 卡普里尼RAM的标准化实施有效地改善了手术患者的静脉瘤风险评估和抗凝剂处方.
- 这项QI项目证明了与医院相关的VTE (HA-VTE) 率的降低,有助于患者的安全.
- 标准化的VTE预防策略对于解决这一重大公共卫生问题至关重要.
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