一项质量改进倡议,以尽量减少在儿童喘恶化中不必要的胸部X射线利用
Mohamed Sakr1, Mohamed Al Kanjo1, Palanikumar Balasundaram2
1From the Department of Pediatrics, Brookdale University Medical Center, One Brookdale Plaza, Brooklyn, N.Y.
Pediatric quality & safety
|April 5, 2024
概括
质量改善举措成功减少了儿童急性喘恶化 (AAE) 病例中不必要的胸部X射线 (CXR). 这个项目使CXR不合规减少了50%以上,使护理与国家指南保持一致.
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
- 放射学利用方法 放射学利用方法
背景情况:
- 国家指导方针建议不要为急性喘恶化 (AAE) 进行常规的胸部X射线 (CXR).
- 在儿科AAE中CXRs的过度利用是一个重大问题.
- 启动了一项质量改进 (QI) 项目,以减少不符合指南的CXR使用.
研究的目的:
- 在12个月内将AAE的儿科患者的指南不遵守CXR的百分比降低50%.
- 实施基于证据的干预措施,以改善对AAE使用CXR的国家准则的遵守.
主要方法:
- 在一个城市2级创伤中心进行了QI项目.
- 在干预之前和之后收集了患有AAE的儿科患者 (2-18岁) 的CXR利用数据.
- 干预措施包括提供者教育,视觉提醒和EHR修改.
主要成果:
- 该研究包括887名符合条件的儿科患者,他们分离了AAE.
- 预干预CXR不合规率为37.5%. 在干预前,CXR不合规率为37.5%.
- 干预后,CXR不合规性降至16.7%,并持续存在.
结论:
- 该QI项目有效地减少了儿科AAE中不必要的CXR利用.
- 结合教育和系统层面的变革的多方面的方法改善了对准则的遵守.
- 这个倡议为其他机构提供了一个模型,以减少儿科AAE中不必要的成像.
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