减少复杂尾炎儿童的术后CT成像:一个儿科外科质量合作质量改进项目
Peter Juviler1, Alicia C Greene2, Terry Fisher3
1Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, United States.
Journal of pediatric surgery
|April 12, 2024
概括
儿科医院可以通过改进超声波的使用,坚持成像协议,并优先考虑辐射管理来减少尾炎的术后CT扫描. 这些策略有助于尽量减少儿童不必要的辐射暴露.
科学领域:
- 儿科手术 儿科手术
- 放射学 放射学是一门学科.
- 提高质量 提高质量
背景情况:
- 计算机断层扫描 (CT) 术后扫描尾炎仍然是常见的,尽管努力减少电离辐射.
- 儿科外科质量协作 (PSQC) 调查了儿童医院中CT使用的差异.
研究的目的:
- 为了确定高和低使用儿童医院之间的复杂尾炎术后CT利用的差异.
- 探索影响儿童尾炎病例术后成像决策过程的因素.
主要方法:
- 分析国家外科质量改进计划PSQC医院的儿科数据 (2020年4月至2021年3月).
- 与来自11家医院的关键利益相关者进行半结构化访谈 (5个低CT,6个高CT).
- 使用理论领域框架 (TDF) 进行面试成绩单的定性分析.
主要成果:
- 五个TDF领域显著影响了CT使用:技能,关于能力的信念,意图/目标,记忆/决策过程和环境.
- 低CT医院对超声波技术人员表现出信任,优先考虑延迟成像 (≥7天),拥有质量改善资源,培养跨学科的信任,并强调辐射管理.
结论:
- 在术后CT使用极端变化的医院提供了对有效策略的见解.
- 关键的改进策略包括开发和遵守成像协议,确保质量改进资源,促进跨学科合作,并倡导辐射管理.
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