降低心脏外科手术患者的手术内白蛋白利用率:质量改善倡议
André J Savadjian1, Brad M Taicher1, Jong Ok La2
1Anesthesiology, Duke University Health System, Durham, North Carolina, USA.
BMJ open quality
|April 25, 2024
概括
一个质量改进项目成功地通过教育和药物托盘更改,在心脏手术患者中降低了手术期间使用的白蛋白. 这一举措显著降低了白蛋白利用率和相关成本,证明了有效的,低成本的干预措施.
科学领域:
- 心脏外科手术 心脏外科手术
- 麻醉学 麻醉学
- 提高质量 提高质量
背景情况:
- 在心脏麻醉中常规的术后使用白蛋白缺乏改善结果的证据.
- 机构数据在心脏手术期间发现了高的手术内白蛋白利用率.
- 启动了一项质量改进项目 (QIP),以减少手术期间的白 administration.
研究的目的:
- 实施和评估一系列旨在减少成人心脏手术患者手术内使用白蛋白的干预措施.
- 评估这些干预措施对白蛋白利用率和相关成本的影响.
主要方法:
- 对成年心脏手术病例 (2019年7月至2022年6月) 的机构多中心外科期期末结果组 (MPOG) 数据的分析.
- 实施QIP,包括教育,加强沟通,调整药物托盘,大回合和提供者反.
- 多变量细分回归模型用于评估白蛋白利用率的变化和干预前后的月度成本.
主要成果:
- 在5767个病例中,有16%的患者接受了手术内白蛋白.
- 干预措施导致避免使用专素的病例逐渐增加.
- 观察到手术内白蛋白利用率 (β=-101.1) 和每月总成本 (β=-7678) 的显著下降.
结论:
- 一个协调的QIP与简单的,低成本的干预措施有效地减少了心脏手术计划中的手术内白蛋白使用.
- 实施的战略带来了巨大的成本节约.
更多相关视频
04:01Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis
Published on: September 8, 2022
2.4K
12:27Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
2.8K
相关概念视频
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...