创伤病房检查清单的实施改善了在开放的四肢骨折中抗生素预防的遵守
Robert D Luke1, Casey P Balio2, Claire K Foley3
1Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
The American surgeon
|April 8, 2024
概括
实施MARTY检查清单改善了对开放骨折的及时抗生素管理. 然而,对于严重受伤的患者来说,合规仍然是一个挑战,突出了未来创伤护理改进的领域.
科学领域:
- 创伤外科 手术 创伤外科
- 患者安全 患者安全
- 抗生素管理局 抗生素管理局
背景情况:
- 美国外科医生学院 (ACS) 的指导方针建议在开放骨折的情况下,在1小时内服用抗生素.
- 检查清单提高了手术环境中的安全性和合规性.
- 该研究评估了MARTY检查清单,用于在开放的四肢骨折中给予抗生素.
研究的目的:
- 评估MARTY创伤室检查清单对抗生素适时给予的影响.
- 改善对开放骨折管理的最佳实践的遵守.
主要方法:
- 追溯的前后研究设计.
- 对2021年 (MARTY前) 和2022年 (MARTY后) 开放骨折的创伤警报的分析.
- 在1小时内和创伤区内对抗生素施用率的比较.
主要成果:
- 在1小时内服用抗生素的比例从MARTY.Y后的57.5%增加到65.5%.
- 在创伤区内给药量从MARTY.Y后的46.0%上升到54.5%.
- 调整后的模型显示,MARTY后及时给予抗生素的几率显著更高 (OR=1.654,P=.038).
结论:
- 通过实施MARTY检查清单,改善了对抗生素管理指南的遵守.
- 对于伤害严重程度得分较高的患者来说,合规性仍然低于最佳水平.
- 这些发现可以为增强创伤护理协议的策略提供信息.
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