使用实施科学来减少在外科ICU中的变异性和高阿片类药物管理
Kyle J Kalkwarf1, Brett J Bailey, Allison Wells
1From the Department of Surgery (K.J.K., A.W., J.W.G., R.Y., N.B., J.M., M.R.K., M.K.K., M.L.R., B.L.D., A.P.), University of Arkansas for Medical Sciences; Department of Pharmacology and Toxicology (B.J.B., A.K.J., R.R.S.), University of Arkansas for Medical Sciences; Center for Implementation Research, Department of Pharmacy Practice, and Department of Psychiatry (G.M.C.), University of Arkansas for Medical Sciences.
The journal of trauma and acute care surgery
|April 30, 2024
概括
实施科学在通风ICU患者中减少了20.1%的阿片类药物处方. 这种方法有效地降低了高剂量阿片类药物使用和重症治疗师之间的差异,减轻了相关风险.
科学领域:
- 关键护理医学 关键护理医学
- 实施科学 实施科学
- 药理学 药理学是指药理学的学科.
背景情况:
- 高剂量和长期使用阿片类药物与耐受性,依赖性和死亡率等不良结果有关.
- 在重症监护室 (ICU) 中,阿片类药物的使用仍然很高,特别是在通风患者中,往往超过必要的疼痛控制水平.
- 这项研究应用了实施科学技术,以解决在外科ICU (SICU) 设置中的过度阿片类药物处方问题.
研究的目的:
- 监测和减少在手术重症监护室内机械通风患者过度处方阿片类药物.
- 评估实施科学策略在修改处方者行为的有效性.
主要方法:
- 一项前性研究是在一个学术医疗中心的封闭SICU中进行了18个月.
- 使用每名患者的吗啡毫克相当量 (MME) 追踪阿片类药物给药,不包括特定的患者群体.
- 强化治疗者接受了盲目的数据,随后是学术细节和审计/反,将他们的处方与单位平均值进行比较.
主要成果:
- 在干预期内,呼吸器患者的阿片类药物利用率下降了20.1%.
- 处方者变化显著减少,处方人数最高的处方者显示阿片类药物使用减少了30.9%.
- 该研究表明,实施科学干预措施对阿片类药物处方模式产生了可衡量的影响.
结论:
- 实施科学方法在减少SICU的阿片类药物处方变化方面是有效的,特别是对于大量处方者.
- 这些干预措施可能会减轻长期高剂量阿片类药物给重症患者的风险.
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