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由护士发起的协议,以改善儿童开口骨折的及时抗生素管理

Kylie Scallon¹, Jessica Lee, Meghan Spencer

¹Author Affiliations: Department of Trauma (Mss Scallon and Lee), Children's Nebraska, Omaha, Nebraska; Department of Emergency (Ms Spencer), Children's Nebraska, Omaha, Nebraska; Division of Emergency Medicine (Drs Timmons and Sneller), Children's Nebraska, Omaha, Nebraska; Division of Pediatric Surgery (Dr Hanna), Children's Nebraska, Omaha, Nebraska; Department of Biostatistics (Ms Schissel), University of Nebraska Medical Center, Omaha, Nebraska; Department of Pediatrics (Drs Timmons and Sneller), University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery (Dr Hanna), University of Nebraska Medical Center, Omaha, Nebraska.

Journal of trauma nursing : the official journal of the Society of Trauma Nurses

|May 14, 2024

概括

一个由护士发起的协议显著改善了儿童开口骨折的及时抗生素给药,使60分钟指南的遵守率从58.5%增加到84.4%. 这种改善持续了24个月,降低了感染风险.

科学领域:

儿科创伤护理儿童创伤护理
预防传染病预防传染病
基于证据的实践实施实施.

背景情况:

早期服用抗生素对于开放骨折至关重要,以预防感染和并发症.
目前的指导方针建议在急诊室到达后60分钟内服用抗生素.
创伤中心在满足60分钟的抗生素管理基准方面面临挑战.

研究的目的:

评估护士发起的协议对儿科开放骨折患者的抗生素给药时间的影响.
评估基于证据的治疗方案的有效性,以改善对重症监护时间表的遵守.
为了确定一个协议是否可以克服在创伤环境中及时提供抗生素的障碍.

主要方法:

一个二级儿科创伤中心的回顾性前后研究设计.
纳入标准:国家创伤数据标准注册公开骨折,截肢或割草机伤害.
在实施协议之前 (2015-2020年) 和之后 (2021-2022年) 的抗生素给药时间的比较,不包括转移的患者.

主要成果:

73名参与者符合纳入标准 (41名在实施前,32名在实施后).
坚持60分钟的抗生素治疗时间显著增加,从协议前的58.5% (24/41) 增加到协议后的84.4% (26/32) (p < .05).
在及时服用抗生素时观察到的改善持续了24个月.

结论:

由护士发起的基于证据的治疗订单有效地减少了开放骨折的抗生素给药时间.
该协议对儿科创伤重症监护的及时性产生了持续的积极影响.
实施标准化协议可以加强对最佳实践的遵守,并改善患者在开放骨折管理中的结果.

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