严重败血症和败血性休克患者的初始护理:下一个ICU质量措施
1Medical Intensive Care Clinical Specialist, Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio.
Hospital pharmacy
|May 15, 2024
概括
针对严重败血症和败血症休克的早期目标导向治疗显著降低了死亡率. 本次审查简化了败血症护理包,突出了药剂师在改善患者结果和遵守基于证据的治疗方案方面的作用.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 提高质量 提高质量
背景情况:
- 2001年关于早期目标导向治疗 (EGDT) 的里程碑式试验彻底改变了严重败血症和败血症休克治疗,通过早期识别和定量复苏来证明死亡率降低.
- 虽然并非所有EGDT成分都被普遍采用,但早期抗生素,液体复苏和血液动力学稳定性等关键元素现在是标准护理.
- 活下来的败血症运动和国家质量论坛已经开发了败血症护理包,以确保最佳,及时的患者管理.
研究的目的:
- 审查支持败血症质量测量和护理包的证据.
- 为了简化败血症护理包的关键组成部分.
- 确定药剂师可以显著影响患者护理和捆绑合规的领域.
主要方法:
- 对支持败血症质量指标的证据的文献综述.
- 关于生存败血症运动和国家质量论坛败血症护理包的分析.
- 在败血症护理包中,药剂师干预措施的识别.
主要成果:
- 早期识别和定量复苏对于减少败血症死亡率至关重要.
- 败血症护理包提供了对初始管理的结构化方法.
- 药剂师在药物管理,抗生素管理和整体患者护理方面发挥着至关重要的作用.
结论:
- 坚持败血症护理包可以改善患者的治疗结果,并降低死亡率.
- 药剂师的参与对于优化败血症治疗和确保遵守基于证据的指南至关重要.
- 简化捆绑组件和澄清药剂师角色可以提高败血症管理协议的有效性.
相关概念视频
01:22Healthcare Associated Infections II: Preventive Measures
2.6K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.6K
01:26Standard Precaution
1.9K
Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
1.9K
01:29Acute Respiratory Failure-V
135
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
135
01:28Pneumonia IV: Management
323
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
323
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
4.2K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
4.2K
01:28Asepsis
2.1K
The condition of being free from disease-causing living pathogens is asepsis. Aseptic techniques include a set of standard practices to achieve asepsis. An example is the regular environmental cleaning of all parts of the healthcare facility and hand hygiene at home before preparing or eating food. Medical and surgical asepsis in healthcare practice protects patients from harmful pathogens, minimizes the risk of contamination of susceptible sites, and reduces the risk of infection transmission.
2.1K