对早产婴儿实施输出管准备指南
Emily B Cobb1, Jennifer Fitzgerald, Karen Stadd
1The University of Maryland, Baltimore (Drs Cobb, Fitzgerald, and Wise); and The Johns Hopkins Hospital, Baltimore, Maryland (Drs Cobb, Stadd, and Gontasz).
概括
实施输出管准备指南显著减少了早产婴儿的呼吸机日数. 这项质量改进项目表明,延长输管时间和第一次输管尝试的时间减少了.
科学领域:
- 新生儿重症监护室新生儿重症监护室
- 改善医疗保健的质量.
- 儿科呼吸系统护理服务
背景情况:
- 在NICU的早产婴儿 (≤32个6/7周妊娠期) 经历了长时间的机械通风.
- 审计显示,这些婴儿中有44%的婴儿被输入管道超过28天,平均为23天的呼吸机.
- 婴儿重症监护室缺乏标准化指导方针,准备进行输出管.
研究的目的:
- 实施和评估一个以证据为基础的输出管准备指南.
- 为了减少早产婴儿机械通风的持续时间.
- 改善新生儿重症监护室 (NICU) 的输出术标准和及时性.
主要方法:
- 一个为期17周的2021年质量改进项目.
- 成立一个多学科委员会和员工教育.
- 使用指南检查清单,临床医生提醒和图表审计来收集数据.
主要成果:
- 实施后显示,输内管的需要减少了>28天.
- 平均总通风器日数减少了.
- 缩短了第一次输出试验的时间.
结论:
- 基于证据的指导方针有效地减少了平均通风机日数.
- 实施标准化指导方针可以改善空气通风早产婴儿的结果.
- QI计划可以优化NICU中的呼吸支持.
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